A STUDY OF ANTIMICROBIAL RESISTANCE PATTERN OF ENTEROCOCCI FROM CLINICAL SPECIMEN WITH SPECIAL REFERENCE TO GLYCOPEPTIDE ANTIBIOTICS IN TERTIARY CARE HOSPITAL

Abstract

Enterococci are nosocomial infections that are resistant to a wide variety of innate
and acquired resistance determinants as well as all therapeutically available
antibiotics. The clinical microbiology lab plays a crucial role in applying accurate,
repeatable, and useful antimicrobial susceptibility testing methods to guide the
appropriate treatment of patients. A prospective study was conducted in the
Department of Microbiology, Grant Govt. Medical College and Sir JJ hospitals
Mumbai Maharashtra India, over eighteen months (April 2021 to October 2023) after
obtaining clearance from the Institutional Ethics Committee, with 250 Enterococci,
isolated from various clinical specimens. The isolates were identified by
morphological and biochemical tests,which were then evaluated for antimicrobial
susceptibility to several antibiotics using the Kirby-Bauer disk diffusion method. The
minimum inhibitory concentration (MIC) of vancomycin and teicoplanin was
measured using agar dilution and micro broth dilution methods, respectively.Of the
250 species of Enterococcus that were isolated, 170 (68%), were E. faecalis,
79(31.6%)were E. faeciumand one isolate of E. durans (0.4%).30.8% were male and
69.2% were female. While77.6% came frominpatient specimens, 22% of the isolates
came from OPD patient specimens.Urine (67.2%) was the most predominant sample.
Gentamicin resistance was found in 47.2% of patients, as was streptomycin
resistance in 46.8%. Among 74 (29.6%) VRE isolates, 89.18% were resistant to
levofloxacin, followed by ciprofloxacin at 82.43%. Van A phenotype was found in 68
(91.89%) of the VRE isolates. Several studies have found an increase in infection
rates and antibiotic resistance among Enterococcus species. High resistance to
routinely used antibiotics has exacerbated the situation, as has the emergence of VRE
strains. To lower the occurrence of VRE, we recommend adequate use of antibiotics
and infection control measures in our healthcare settings.