Sahu, L., Dash, M., Paty, B., Purohit, G., Chayan, N. (2015). Enterococcal Infections and Antimicrobial Resistance in a Tertiary Care Hospital, Eastern India. Afro-Egyptian Journal of Infectious and Endemic Diseases, 5(4), 255-264. doi: 10.21608/aeji.2015.17846
Llalli S Sahu; Muktikesh Dash; Bimoch P Paty; Gopal K Purohit; Nirupama Chayan. "Enterococcal Infections and Antimicrobial Resistance in a Tertiary Care Hospital, Eastern India". Afro-Egyptian Journal of Infectious and Endemic Diseases, 5, 4, 2015, 255-264. doi: 10.21608/aeji.2015.17846
Sahu, L., Dash, M., Paty, B., Purohit, G., Chayan, N. (2015). 'Enterococcal Infections and Antimicrobial Resistance in a Tertiary Care Hospital, Eastern India', Afro-Egyptian Journal of Infectious and Endemic Diseases, 5(4), pp. 255-264. doi: 10.21608/aeji.2015.17846
Sahu, L., Dash, M., Paty, B., Purohit, G., Chayan, N. Enterococcal Infections and Antimicrobial Resistance in a Tertiary Care Hospital, Eastern India. Afro-Egyptian Journal of Infectious and Endemic Diseases, 2015; 5(4): 255-264. doi: 10.21608/aeji.2015.17846
Enterococcal Infections and Antimicrobial Resistance in a Tertiary Care Hospital, Eastern India
1Microbiology Department, S.C.B Medical College and Hospital, Utkal University, Cuttack, Odisha, India.
2Microbiology Department, S.C.B Medical College and Hospital, Utkal University, Cuttack, Odisha, India.
3Biotechnology School, KIIT University, Bhubaneswar, Odisha, India.
Abstract
Background and study aim: During last two decades, there has been a world-wide trend in increasing occurrence of entero-coccal infections in the hospitals. The aim of present study was to determine the spectrum of enterococcal infections, speciesprevalence, antimicrobial resistance and characteristics of vancomycin resistant enterococci (VRE) in a tertiary care hospital, Eastern India.
Patients and Methods: Between January 2013 and July 2014, 152 Enterococcus species were obtained from clinical samples. Enterococci were identified using standard biochemical tests. Antimicrobial susceptibility was tested by Kirby-Bauer disk diffusion according to Clinical & Laboratory Standards Institute (CLSI) guidelines.VRE agar base was used to screen VRE isolates. Minimum inhibitory concentration (MIC) values of VRE isolates were determined using Epsilometer-test. VRE isolates were also examined by PCR to detect vanA gene. Results: From 1602 clinical samples, 961 (60%) were culture positive and 152(15.8%) enterococcal isolates were obtained. Most common species isolated was E. faecalis (63.8%) followed by E. faecium (35.5%). Majority of enterococcal infections were detected from ICUs and surgical wards and clinically presented as UTIs. Disk diffusion method showed 67.1% were resistant to penicillin, 61.2% ampicillin, 58.5% ciprofloxacin, 46.7% high-level gentamicin, 42. 8% high-level streptomycin, 7.9% teicoplanin and none to linezolid. Twenty (13.2%) enterococcal isolates were vancomycin resistant in VRE screen and disk diffusion method. Epsilometer-test of VRE isolates showed 8 (40%) isolates were resistant and 9 (45%) were intermediately resistant. From 20 VRE isolates, six showed VanA and two VanB phenotypes and all six VanA phenotypes had vanA gene cluster. Conclusion: More accurateand reliable MIC determination tests should be performedin all suspected VRE isolates. Confirmatory PCR is required for identifying resistant gene cluster.
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