Enterococcal Urinary Taract Infection: An Emerging Threat

Abstract

INTRODUCTION:Enterococcus faecalis is a frequent cause of hospital acquired urinary tract infection and is being increasingly recognized as a cause of community acquired urinary tract infection. The organism is resistant to commonly used antibiotics, thereby limiting treatment options. OBJECTIVES: To study the epidemiology and resistogram of enterococcal urinary tract infections. MATERIALS AND METHODS:In this study of two years duration (August 2008 to July 2010), we included symptomatic cases of urinary tract infection which showed significant bacteriuria due to Enterococcus faecalis as the sole pathogen. The data concerning the age, gender, type of urinary tract infection were collected from the patients' records. Urine analysis was done following standard microbiological methods, and the antibiogram was done following standard disc-diffusion method on the Mueller-Hinton agar. RESULTS: Community acquired E. faecalis urinary tract infection (50.4%) was as common as nosocomial E. faecalis urinary tract infection (49.6%). Nosocomial urinary tract infections occurred most frequently in the gynecology wards. Of all E. faecalis urinary tract infections more than half occurred in the 21-50 year age group (52.3%) while another 13.04% of cases occurred in 1-5 year age group. There was resistance to ciprofloxacin (86.1%), amikacin (77.4%), cotrimoxazole (78.3%) and imipenem (52.2%) among the enterococcal isolates. Vancomycin resistant enterococci (3.5%) were also isolated. CONCLUSION: Enterococcal urinary tract infection can present as both community acquired and hospital acquired infections. The incidence of drug resistance in E. faecalis is high.

Phenotype–Genotype Correlations and Distribution of Key Virulence Factors in Enterococcus faecalis Isolated from Patients with Urinary Tract Infections

“…15 The Fsr quorum-sensing system controls biofilm development through regulating the production of gelatinase. 14 E. faecalis is now emerging as a serious cause of both hospital-and community-acquired UTIs, 16,17 which can lead to serious, fatal complications like bacteremia. 16 While no particular set of genes has been proposed to be associated with UTIs, no systematic investigation of phenotype-genotype concordance has been established for this clinically important type of infection.…”

“…14 E. faecalis is now emerging as a serious cause of both hospital-and community-acquired UTIs, 16,17 which can lead to serious, fatal complications like bacteremia. 16 While no particular set of genes has been proposed to be associated with UTIs, no systematic investigation of phenotype-genotype concordance has been established for this clinically important type of infection. Guided by a prior study 18 on enterococci isolated from various tissues, we launched the current study to phenotypically and genotypically investigate and correlate virulence factors, such as biofilm formation, gelatin and casein hydrolysis, as well as blood hemolysis, in E. faecalis clinical isolates from patients with community-acquired UTIs in Egypt.…”

Changing Prevalence and Antimicrobial Susceptibility Profiles by Uropathogens : A Study in India

“…Multi drug resistance in urinary isolates of Enterococcus in various Indian studies ranges from 55.5% to 78.8%. [23,24] CONCLUSION: Various studies on antibiotic resistance are emerging with an intention to bring into lime light about the resistance that is developing among the microorganisms towards the antibiotics. Though the approaches are same, the results are showing entirely different conclusions from time to time.…”