Vancomycin-resistant enterococci causing bacteriuria in hospitalized patients from Northwest India

Abstract

Background: Vancomycin-resistant enterococci (VRE) are an important opportunistic pathogen in hospitalized patients due to their resistance to commonly administered antimicrobial agents. Material and Methods: A pilot study consisting of 100 urinary enterococcal isolates with significant bacteriuria (>105 CFU/ml) was conducted to assess the resistance pattern in our hospital. Culture, identification, and antibiotic sensitivity testing were performed as per standard protocols. Resistance to vancomycin was confirmed by minimum inhibitory concentration method using commercially available E strips (Hi Media). Results: Fifty-four percent (54/100) of isolates were Enterococcus faecalis, 33% (33/100) Enterococcus faecium followed by 13% (13/100) nonfaecalis nonfaecium species. 4% (4/100) of enterococci were vancomycin resistant out of which 1 (25%) was resistant to linezolid. All VRE were sensitive to nitrofurantoin. Conclusion: Emerging resistance to vancomycin in cases of significant bacteriuria found in our study raises a concern for reserving higher antibiotics such as linezolid, daptomycin, and quinupristin-dalfopristin. Efforts are required to assess the clinical significance of VRE in terms of colonization and infection and switch to evidence-based treatment plan.