Current Trend of Antibiogram of Enterococcus Species Isolated From Urine Samples of Patients Attending Tertiary Care Center, Pokhara

Abstract

Background: Enterococcus an important uropathogen has appeared to be of great therapeutic challenge globally due to its intrinsic and acquired resistance to multiple antibiotics. High level aminoglycoside and vancomycin resistant Enterococcus has narrowed the treatment options. Thus, the aim of this study was to detect the current antibiogram trend of Enterococcus species isolated from urine samples. Methods: A descriptive cross-sectional study was conducted in urine sample of patients attending Gandaki Medical College Teaching Hospital from September 2021 to May 2022. Ethical clearance was obtained from Institutional Review Committee. Enterococcus species was isolated and antibiotic susceptibility test was performed by Kirby-Bauer disc diffusion method. Simple random sampling was done and data was analyzed by Statistical Package for Social Science (SPSS) version 20. Results: A total of 61 (10.62 %) Enterococcus species were isolated from 574 culture positive urine samples. Enterococcus isolates were highly susceptible to linezolid 60 (98.4%), vancomycin 56 (91.8%) and nitrofurantoin 50 (82.0%) whereas less susceptible to ampicillin 16 (26.2%). Multidrug resistant Enterococcus was identified commonly from 25 (73.5%) in-patients. Nitrofurantoin was sensitive among 4 (80.0%) vancomycin resistant isolates. Only 4 (16.0%) Enterococcal isolates were sensitive to both ampicillin and high-level gentamicin. Conclusions: Emergence of multidrug resistant Enterococcus in our institution is worrisome. Nitrofurantoin remains a useful drug and shows high efficacy in vitro against emerging vancomycin resistant isolates. Combination of ampicillin and high-level gentamicin is used to treat complicated urinary tract infection; however, it seems less effective in our scenario.