Objectives:
Vancomycin Resistant Enterococcus (VRE) species has been increasing and is now of serious concern. The aim of the study was to find the prevalence of VRE bacteremia at our institution. Also, the demographic pattern, associated risk factors, sensitivity pattern and outcomes associated with bacteremia caused by VRE were also estimated.
Materials and Methods:
This observational study was done in the Microbiology department of our institute from April 2022 to June 2023. All patients with blood cultures positive for Enterococcus species for the first time were included in the study. Identification was done using MALDI-Tof MS. Antimicrobial Sensitivity Testing was and interpreted using Clinical and Laboratory Standards Institute (CLSI) 2023 M-100. The demographic details, risk factors, and the clinical outcome of the patients were collected and analyzed.
Statistical Analysis:
All the data were entered in Excel sheets. The univariate analysis was done for the risk factors and outcome of the patients with VRE bacteremia and VSE (Vancomycin Sensitive Enterococcus) bacteremia. 95% confidence interval, Odd’s ratio and p-value was estimated.
Results:
During the study period, 29086 blood culture bottles were received. Of these, 2016 (6.93%) bottles flagged positive. Enterococcus species were isolated from 256 (12.69%) blood cultures. Of the 256 Enterococcus isolates, 45 (17.57%) isolates were Vancomycin resistant. Most common species were Enterococcus faecium (n=42; 93.33%). Most of the patients belonged to the age group 41-60 years (31.11%). Diabetes mellitus and neutropenia were found to be significant risk factors. All the isolates showed 100% resistance to Teicoplanin, Ampicillin, Ampicillin-sulbactam and Levofloxacin. Mortality was significantly higher in patients with VRE bacteremia as compared to patients with Vancomycin Sensitive Enterococcal (VSE) bacteremia.
Conclusion:
Proper implementation of antimicrobial stewardship rules in the hospital is the best way to overcome the increasing trend of resistance.