Vancomycin Resistant Enterococcal Urinary Tract Infection: A Potential Threat

Introduction: Enterococci are considered less virulent organisms, but have incurred recognition for being notorious for their acquisition and transfer of resistance. The greatest potential threat posed by enterococci is vancomycin resistance. The transfer of enterococcal vancomycin resistance to Sta...

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Main Authors: Sabba Mussadiq, Rajesh Kumar Verma, Dharmendra Prasad Singh, Mohd Mubashir Ali Khan
Format: Article
Language:English
Published: JCDR Research and Publications Pvt. Ltd. 2023-04-01
Series:National Journal of Laboratory Medicine
Subjects:
Online Access:https://njlm.net/article_fulltext.aspx?issn=0973-709x&year=2023&month=April&volume=12&issue=2&page=MO01%20-%20MO05&id=2710
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author Sabba Mussadiq
Rajesh Kumar Verma
Dharmendra Prasad Singh
Mohd Mubashir Ali Khan
author_facet Sabba Mussadiq
Rajesh Kumar Verma
Dharmendra Prasad Singh
Mohd Mubashir Ali Khan
author_sort Sabba Mussadiq
collection DOAJ
description Introduction: Enterococci are considered less virulent organisms, but have incurred recognition for being notorious for their acquisition and transfer of resistance. The greatest potential threat posed by enterococci is vancomycin resistance. The transfer of enterococcal vancomycin resistance to Staphylococcus aureus has been achieved making scientists apprehensive of its consequences. Aim: To find the prevalence of Vancomycin-Resistant Enterococci (VRE) and to determine the antimicrobial resistance pattern in enterococcal urinary isolates. Materials and Methods: A cross-sectional study was carried out on all urinary samples suspected of Urinary Tract Infection (UTI) received for duration of one year from April 2021 to March 2022 in the Department of Microbiology at Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh. Enterococci were isolated and identified with a VITEK-2® COMPACT (bioMérieux) automated system. The antibiotic susceptibility pattern was determined by Kirby-Bauer disc diffusion method. Further, confirmation of VRE was done by Minimum Inhibitory Concentration (MIC) E-test. Results: A total of 128 urinary enterococcal isolates were identified with the male-to-female ratio 1.37:1 and mean age of patients was 37.18±22.64 years. Out of total, 71.87% were identified as Enterococcus faecalis followed by 24.21% Enterococcus faecium and the rare species (4%) including E.durans, E.hirae, E.raffinosus. The prevalence of VRE was found to be 8.6%. Maximum resistance by isolates has been shown against ampicillin, erythromycin, ciprofloxacin, and doxycycline. All isolates were sensitive to linezolid. Nitrofurantoin resistance was observed in 4.34% and 25.80% of E.faecalis and E.faecium isolates respectively. Conclusion: In this study, it was revealed that the emergence of VRE in urinary isolates with antimicrobial resistance was higher among E. faecium. All this puts pressure on strict compliance with a multidimensional approach with collaboration of antibiotic stewardship, educational and surveillance programs.
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spelling doaj.art-e6acfa1847cd49788b8bcdfac9f628272023-03-17T08:20:31ZengJCDR Research and Publications Pvt. Ltd.National Journal of Laboratory Medicine2277-85512455-68822023-04-01122MO01MO0510.7860/NJLM/2023/60840.2710Vancomycin Resistant Enterococcal Urinary Tract Infection: A Potential ThreatSabba Mussadiq0Rajesh Kumar Verma1Dharmendra Prasad Singh2Mohd Mubashir Ali Khan3enior Resident, Department of Microbiology, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India.Professor, Department of Microbiology, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India.Professor, Department of Microbiology, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India. Associate Professor, Department of Urology, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India. Introduction: Enterococci are considered less virulent organisms, but have incurred recognition for being notorious for their acquisition and transfer of resistance. The greatest potential threat posed by enterococci is vancomycin resistance. The transfer of enterococcal vancomycin resistance to Staphylococcus aureus has been achieved making scientists apprehensive of its consequences. Aim: To find the prevalence of Vancomycin-Resistant Enterococci (VRE) and to determine the antimicrobial resistance pattern in enterococcal urinary isolates. Materials and Methods: A cross-sectional study was carried out on all urinary samples suspected of Urinary Tract Infection (UTI) received for duration of one year from April 2021 to March 2022 in the Department of Microbiology at Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh. Enterococci were isolated and identified with a VITEK-2® COMPACT (bioMérieux) automated system. The antibiotic susceptibility pattern was determined by Kirby-Bauer disc diffusion method. Further, confirmation of VRE was done by Minimum Inhibitory Concentration (MIC) E-test. Results: A total of 128 urinary enterococcal isolates were identified with the male-to-female ratio 1.37:1 and mean age of patients was 37.18±22.64 years. Out of total, 71.87% were identified as Enterococcus faecalis followed by 24.21% Enterococcus faecium and the rare species (4%) including E.durans, E.hirae, E.raffinosus. The prevalence of VRE was found to be 8.6%. Maximum resistance by isolates has been shown against ampicillin, erythromycin, ciprofloxacin, and doxycycline. All isolates were sensitive to linezolid. Nitrofurantoin resistance was observed in 4.34% and 25.80% of E.faecalis and E.faecium isolates respectively. Conclusion: In this study, it was revealed that the emergence of VRE in urinary isolates with antimicrobial resistance was higher among E. faecium. All this puts pressure on strict compliance with a multidimensional approach with collaboration of antibiotic stewardship, educational and surveillance programs.https://njlm.net/article_fulltext.aspx?issn=0973-709x&year=2023&month=April&volume=12&issue=2&page=MO01%20-%20MO05&id=2710bladder infectiongram-positive cocciprevalence
spellingShingle Sabba Mussadiq
Rajesh Kumar Verma
Dharmendra Prasad Singh
Mohd Mubashir Ali Khan
Vancomycin Resistant Enterococcal Urinary Tract Infection: A Potential Threat
National Journal of Laboratory Medicine
bladder infection
gram-positive cocci
prevalence
title Vancomycin Resistant Enterococcal Urinary Tract Infection: A Potential Threat
title_full Vancomycin Resistant Enterococcal Urinary Tract Infection: A Potential Threat
title_fullStr Vancomycin Resistant Enterococcal Urinary Tract Infection: A Potential Threat
title_full_unstemmed Vancomycin Resistant Enterococcal Urinary Tract Infection: A Potential Threat
title_short Vancomycin Resistant Enterococcal Urinary Tract Infection: A Potential Threat
title_sort vancomycin resistant enterococcal urinary tract infection a potential threat
topic bladder infection
gram-positive cocci
prevalence
url https://njlm.net/article_fulltext.aspx?issn=0973-709x&year=2023&month=April&volume=12&issue=2&page=MO01%20-%20MO05&id=2710
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AT rajeshkumarverma vancomycinresistantenterococcalurinarytractinfectionapotentialthreat
AT dharmendraprasadsingh vancomycinresistantenterococcalurinarytractinfectionapotentialthreat
AT mohdmubashiralikhan vancomycinresistantenterococcalurinarytractinfectionapotentialthreat