Profile of Enterococcus species isolated from cases of urinary tract infections in a tertiary care hospital in Uttar Dinajpur: a retrospective study
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20262284Keywords:
Antibiotic resistance, Enterococcus species, Urinary tract infectionAbstract
Background: Urinary tract infection (UTI) is a leading cause of morbidity and mortality worldwide. Enterococcus species is a commensal in our gastrointestinal tract and a leading cause of UTI in humans. Enterobacterales group were the common organisms causing UTI, but in the recent years there is increase in prevalence of other organisms. This retrospective study was undertaken to understand the profile of Enterococcus species causing UTIs and their antibiogram.
Methods: This study was conducted in the department of microbiology, Raiganj Government Medical College for a period of 1 year from January 2025 to December 2025. Urine samples were received in sterile universal containers and cultured using standard precautions in Hichrome UTI agar. Identification (ID) and antibiotic susceptibility testing (AST) were performed by using Vitek II ID and AST cards.
Results: Out of 2908 urine samples received, 356 (12.2%) showed growth of organisms. Out of 356 isolates, the most common isolate was Escherichia coli 41.0%, followed by Enterococcus species 30.6%. Among the Enterococcus species, E. faecalis were 76.1% and E. faecium 23.9%. The most sensitive antibiotic was linezolid showing 100% susceptible, followed by teicoplanin 89.9% susceptible. The Enterococcus species were highly resistant to ampicillin. The prevalence of VRE was found to be 25.6%.
Conclusions: The increase in drug resistance and treatment failure makes it important for proper identification and AST for targeted therapy. Proper diagnosis and starting treatment at correct time will decrease the morbidity and mortality related to these infections in humans.
References
Facklam RR, Teixeira LM. “Enterococcus”. In: Lollier L, Balows A, and Sussman M, Eds., Topley and Wilson’s Microbiology and Microbial Infections. 9th edn. Oxford University Press, New York, NY, USA; 1998:669-682.
Mandell G, Bennett J, Dolin R. Principles and Practice of Infectious Disease. 6th ed. Elsevier; 2005.
Ronald AR, Pattulo MS. The natural history of urinary infection in adults. Med Clin North Am 1991;75:299-312.
Low DE, Keller N, Barth A, Jones RN. Clinical prevalence, antimicrobial susceptibility, and geographic resistance patterns of enterococci: results from the Sentry Antimicrobial Surveillance Program, 1997-1999. Clin Infect Dis. 2001;32(2):Suppl:33-45.
Werner G, Coque TM, Hammerum AM. Emergence and spread of vancomycin resistance among enterococci in Europe. Euro Surveill. 2008;13:1-11.
French GL. Enterococci and vancomycin resistance. Clin Infect Dis. 1998;27:S75-83.
Huycke MM, Sahm DF, Gilmore MS. Multiple-drug resistant Enterococci: the nature of the problem and an agenda for the future. Emerg Infect Dis. 1998;4(2):239-49.
Jain S, Kumar A, Kashyap B, Kaur RI. The clinic epidemiological profile and the high-level aminoglycoside resistance in Enterococcal septicaemia at a tertiary care hospital in east Delhi. Int J App Basic Med Res. 2011;1(2):80-3.
Carmeli Y, Eliopoulos G, Mozaffari E, Samore M. Health and economic outcomes of vancomycin-resistant enterococci. Arch Intern Med. 2002;162(19):2223-8.
Christy VR, Athinarayanan G, Mariselvam R, Dhasarathan P, Singh R. Epidemiology of urinary tract infection in south India. Biomed Res Clin Pract. 2019;4:1-5.
Moses V, Jerobin J, Nair A, Sathyendara S, Balaji V, George IA, et al. Enterococcal bacteremia is associated with prolonged stay in the medical intensive care unit. J Glob Infect Dis. 2012;4:26-30.
Sharma B, Mohan B, Sharma R, Lakhanpal V, Shankar P, Singh SK, et al. Evaluation of an automated rapid urine culture method for urinary tract infection: Comparison with gold standard conventional culture method. Indian J Med Microbiol. 2023;42:19-24.
Rajni E, Jain A, Garg VK, Sharma R, Vohra R, Jain SS. Providencia causing urinary tract infections: Are we reaching a dead end? Indian J Crit Care Med. 2022;26:448-53.
Ahirwar N, Singha TK, Srivastava M, Pal M. Epidemiological study of the antimicrobial resistance pattern of a suspected urinary tract infection in a super surgical, super specialty hospital in Northern India. Med Sci Forum. 2024;24:16.
Tessema NN, Ali MM, Zenebe MH. Bacterial associated urinary tract infection, risk factors, and drug susceptibility profile among adult people living with HIV at Haswassa university comprehensive specialized hospital, Hawassa, Southern Ethiopia. Sci Rep. 2020;10:10790.
Smout E, Palanisamy N, Valappil SP. Prevalence of vancomycin-resistant Enterococci in India between 2000 and 2022: a systematic review and meta-analysis. Antimicrob Resist Infect Control. 2023;12:79.
Sumangala B, Sharlee R, Shetty NS. Identification of Enterococcus faecalis and E. faecium among enterococci isolated from clinical samples in a teaching hospital Mandya Institute of Medical Sciences, Mandya. Indian J Microbiol Res. 2020;7:284-7.
Yenisehirli G, Yenisehirli A, Bulut Y, Ozveren G. Antimicrobial resistance of enterococci isolated from urine cultures. Klimik J. 2016;29:112-6.
Yilema A, Moges F, Tadele S, Endris M, Kassu A, Abebe W, et al. Isolation of enterococci, their antimicrobial susceptibility patterns and associated factors among patients attending at the university of Gondar teaching hospital. BMC Infect Dis. 2017;17:276.
Medina-Polo J, Sopeña-Sutil R, Benítez-Sala R, Lara-Isla A, Alonso-Isa M, Gil-Moradillo J, et al. Prospective study analyzing risk factors and characteristics of healthcare-associated infections in a urology ward. Investig Clin Urol. 2017;58:61-9.
Cao D, Shen Y, Huang Y, Chen B, Chen Z, Ai J, et al. Levofloxacin versus ciprofloxacin in the treatment of urinary tract infections: evidence-based analysis. Front Pharmacol. 2021;12:658095.
Sattari-Maraji A, Jabalameli F, Farahani NN, Beigverdi R, Emaneini M. Antimicrobial resistance pattern, virulence determinants and molecular analysis of Enterococcus faecium isolated from children infections in Iran. BMC Microbiol. 2019;19:156.
Perdana MA, Wahyuni DD, Yunita R. Characteristics and susceptibility pattern of catheter-associated urinary tract infections (CAUTI) bacteria in Indonesia: a study in a national reference hospital of Sumatra region 2020-2021. Narra J. 2023;3:e436.
Anjum F, Naim A, Imran ZP, Haroon U. Antibiotic resistance and susceptibility profile, with biofilm forming potential of clinically isolated Enterococcus specie from blood and urine samples. J Sustain Environ. 2023;2:15-22.
Ohri S, Singh K, Sidhu SK, Oberoi L. Prevalence and antimicrobial resistance in Enterococcus species. Asian J Pharm Clin Res. 2023;16:30-3.
Chanda S, Suryawanshi R, Megha GK, Khutade K. Phenotypic characterization and antibiotic susceptibility pattern of clinical isolates of enterococci with special emphasis on vancomycin resistance. Int J Sci Healthcare Res. 2022;7:379-88.
Smout E, Palanisamy N, Valappil SP. Prevalence of vancomycin-resistant Enterococci in India between 2000 and 2022: a systematic review and meta-analysis. Antimicrob Resist Infect Control. 2023;12:79.
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