PREVALENCE OF Enterococcus SPECIES FROM VARIOUS CLINICAL SPECIMENS IN SHRI SATHYA SAI MEDICAL COLLEGE AND RESEARCH INSTITUTE WITH SPECIAL REFERENCE TO SPECIATION & THEIR RESISTANCE TO VANCOMYCIN

Abstract

Introduction-Enterococci are part of the normal intestinal flora of humans and animals but have also emerged as important pathogens responsible for serious infections in hospital and community acquired infections. According to recent surveys, Enterococci remain in the top 3 most common pathogens that cause nosocomial infections. Aim-To process all the clinical samples from various departments in our hospital, for the isolation of Enterococci sp. To speciate the isolates & to have the resistance pattern of the isolates to Vancomycin Methods and Material-A total of 928 samples were collected from both out patients and in patients in all clinical departments and transported to microbiology laboratory. Specimens were processed by inoculating on to Mac Conkeys agar, blood agar, nutrient agar and Pfizer selective media and incubated at 37 0 C for 24 -48 hours. Enterococci were identified by their typical arrangement in Gram stain, Bile esculin test and salt tolerance test. Speciation was done by subjecting the isolates to a battery of biochemical tests. Antimicrobial susceptibility patterns were determined by performing Kirby-Bauer disc diffusion method and Minimum Inhibitory Concentration (MIC) values were identified by Tube & Agar dilution method. Results-A total of 928 samples. Among these, 647 (69.72%) were culture positive with different isolates and 281 (30.28%) were culture negative. Among 647 culture positive cases, 100 (15.46%) were Enterococcus faecalis. Antimicrobial susceptibility & MIC done as per standard protocols. The E. Faecalis showed 99% sensitive to Vancomycin. The resistance to Vancomycin was further confirmed by MIC both Agar &Tube dilution methods, in which the MIC was: 32µg/ml in one isolate. Conclusions-Species level identification of Enterococcus is not only important for epidemiological study, but also for analysing the drug resistant pattern. Effective detection of Vancomycin resistance in laboratory helps in reducing the morbidity and mortality due to VRE in hospitalized patients.

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“…Two other studies from Bangladesh reported isolation rates of E. faecalis as 62.5% by Islam and 71.18% by Akhter 14 that were almost similar to our present study. 1,14 The isolation rate of Enterococcus Faecalis from India by Mendiratta et al, 15 (85.3%) and Jada & Jayakumar et al, 5 (100%) from Kancheepuram were higher than our present study. 5,15 Reasons could be the predominance of E. fecalis in the endogenous flora of the body.…”

“…1,14 The isolation rate of Enterococcus Faecalis from India by Mendiratta et al, 15 (85.3%) and Jada & Jayakumar et al, 5 (100%) from Kancheepuram were higher than our present study. 5,15 Reasons could be the predominance of E. fecalis in the endogenous flora of the body. 16 After E. faecalis, 1 isolate of E. gallinarum (0.95%)has been detected among 105 isolated Enterococci in our present study.…”

“…According to recent surveys, Enterococci remain in the top 3 most common pathogens that cause nosocomial infections. 5 In this study, Table 1 shows that the prevalence of urinary tract infection (UTI) caused by enterococci was 12.34%. These findings agree with the report conducted in Brasil by Neto et al, 9 was 11%.…”

“…4 Enterococcus faecalis and Enterococcus faecium are the most prevalent species cultured from humans, accounting for more than 90% of clinical isolates. 5 Species identification is useful for epidemiological investigation of an outbreak and also for clinical decisions, particularly with regard to therapy, as antimicrobial susceptibility differs by species. 6 Biochemical tests for species identification are not performed routinely as they are laborious and time consuming; so to overcome the problem, the use of molecular methods has been suggested.…”

Study of the Prevalence of Vancomycin Resistant as Well as High Level Gentamicin Resistant Enterococci in Various Clinical Specimens at MGM Medical College and LSK Hospital, Kishanganj, Bihar

“…P.J. Desai et al (2001) found 22.19% prevalence of Enterococci in various clinical specimens, (10) whereas Susil Kumar Jada et al (2012), (11) reported the prevalence of enterococci 15.46%, among different organisms. Distribution of Enterococci positive specimens in indoors and outdoors of various departments: Indoor-266 (95%), OPD-14 (5%).…”