Epidemiological Profile, Speciation and Antibiogram of Enterococcus Species in the Era of Resistance

Enterococcus species have now emerged as leading causes of nosocomial infections. Speciation and antibiotic susceptibility testing (AST) are needed for these organisms due to their increasing resistance to various antibiotics. As geographic diversity contributes to varied resistant patterns in these organisms, the present study was conducted with the objective to analyse the prevalence, clinicodemographic profile and speciation of enterococci from various clinical samples, and to assess their antimicrobial resistance (AMR) pattern at our setting. A prospective observational study was carried out for a period of six months at a tertiary care hospital in Telangana, India. Clinical samples which showed growth of pathogens during the study period were included. Enterococcus spp. were identified by appropriate biochemical tests followed by AST. 106 Enterococcus spp. were isolated among 1864 samples with growth during the study period. Prevalence of enterococcal infections was 5.6%. Male population, age distribution (31-40 yrs), gynaecology ward inpatients, and urine samples had significant (p value <0.05) enterococcal isolation. Enterococcus faecalis (61.3%) was the commonest isolate. High-level streptomycin (HLS) resistance was 33.01% and high-level gentamicin (HLG) resistance was 37.7%. Although resistance to commonly used antibiotics was high, vancomycin resistance was only 6.6%, and linezolid resistance was 0% at our setting. The clinicodemographic profile of patients has to be scrutinized when dealing with enterococcal infections. There is geographic variation in the resistance patterns of enterococci, which needs to be addressed before institution of definitive therapy. Speciation not only helps epidemiology, but also guides in tracking resistance patterns emerging among them.