Enterococcal infection rates from various clinical samples and phenotypic characterization of Vancomycin-resistant enterococcus (VRE) at tertiary care hospital

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Original Article

Author Details : Nidhi Sood, Neha Baldaniya*, Rosy Parmar, Asha Mandalia, Hemanshi Maheta

Volume : 10, Issue : 4, Year : 2024

Article Page : 371-377

https://doi.org/10.18231/j.ijmmtd.2024.062

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Abstract

Background: Enterococci are increasingly prevalent in both community and hospital-acquired infections, posing a significant challenge due to their resistance to common antibiotics, including vancomycin. Given the lack of specific prevalence data at our hospital, we conducted a study to isolate and characterize Enterococcus from various clinical samples and assess their resistance profiles, particularly to vancomycin, to guide more effective treatment strategies and improve patient outcomes.
Materials and Methods: All clinical samples such as blood, urine, pus, sputum, CSF and other fluids from the hospital were processed using standard bacteriological procedures, including Gram staining and culture on selective media. The enterococcal isolates were identified using conventional biochemical tests, including catalase test, bile esculin hydrolysis, and carbohydrate utilization tests. Antimicrobial susceptibility testing was performed according to CLSI guidelines.
Results: From a total of 12,013 clinical specimens, 50 enterococcal isolates were recovered. Among these, 34% were from blood, followed by 30% from urine, 16% from pus, 14% from fluids, 4% from sputum, as well as 2% from CSF. A total of 52% of the isolates were from indoor patients, and 62% were from women. Enterococcus faecalis was the second most common species, after Enterococcus faecium. The antibiotic susceptibility pattern demonstrated 100% susceptibility to linezolid. Resistance to vancomycin and teicoplanin was observed in 20% and 28% of isolates, correspondingly, with 70% of isolates exhibiting
resistance to both vancomycin and teicoplanin.
Conclusions: The present investigation reveals a high rate of VRE (Vancomycin-resistance enterococcus) isolates in our hospital, with a majority of isolates showing resistance to both teicoplanin and vancomycin. The situation worsens due to the Van A phenotype and the multidrug resistance these medicines demonstrate, which leaves fewer therapeutic options for the treatment. This highlights how important it is to carry out routine surveillance to quickly identify and manage infections caused by Vancomycin-resistant enterococcus in both hospitals and the community..
 

Keywords: Enterococcus, Vancomycin­resistant enterococci (VRE), Van A phenotype, Van B phenotype, Van C phenotype, Enterococcus faecium, Enterococcus faecalis, Multidrug resistance

How to cite : Sood N, Baldaniya N, Parmar R, Mandalia A, Maheta H, Enterococcal infection rates from various clinical samples and phenotypic characterization of Vancomycin-resistant enterococcus (VRE) at tertiary care hospital. IP Int J Med Microbiol Trop Dis 2024;10(4):371-377

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