Enterococcal Infections and Antimicrobial Resistance in a Tertiary Care Hospital, Eastern India | ||||
| Afro-Egyptian Journal of Infectious and Endemic Diseases | ||||
| Article 6, Volume 5, Issue 4, December 2015, Page 255-264 PDF (394.74 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/aeji.2015.17846 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Llalli S Sahu1; Muktikesh Dash  1; Bimoch P Paty2; Gopal K Purohit3; Nirupama Chayan1
| ||||
| 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 accurate and reliable MIC determination tests should be performedin all suspected VRE isolates. Confirmatory PCR is required for identifying resistant gene cluster. | ||||
| Keywords | ||||
| enterococci; E. faecalis; E. faecium; VRE; vanA gene | ||||
|
Statistics Article View: 178 PDF Download: 358 |
||||
