RISK FACTORS AND OUTCOMES OF ENTEROCOCCUS SPECIES ISOLATED FROM CLINICAL SPECIMENS

Abstract

Introduction: Enterococci are the most common aerobic and facultative anaerobic gram-positive cocci. They show intrinsic resistance to many antibiotics, acquire resistance genes and are capable of transferring resistance genes. Immunosuppression, abdominal surgery, structural abnormalities of urinary tract, long hospital/ICU stay, previous antibiotic use, mechanical ventilation, etc. are all risk factors for enterococcal infections. Objectives: A study was undertaken to nd out the risk factors and outcomes of Enterococcus species isolated from clinical specimens. Material and Methods: Single enterococcal isolates recovered from clinical specimens received for bacterial culture in this hospital during a period of one and half years were included in the study. Clinical details of the patient and risk factors were noted down in a structured proforma. Enterococci were identied and speciated by standard biochemical tests. Patient was followed up to see the outcome. Total 96 enterococci Results: were isolated during this period from hospitalized patients, out of which 86 were Enterococcus faecalis, 8 E. faecium and 2 E. solitarius. Out of these, 4.2% isolates were vancomycin resistant enterococci. Out of 96, 52.1% had a hospital stay >7 days, 28.1% were on mechanical ventilation and 19.8% had central line insertion. In this study, 26% patients with enterococcal infection expired. Mortality among patients with E. faecium infection was more (62.5%) than among patients with E. faecalis infection (23.3%). Mortality in patients whose hospital stay was >7 days was 42%, whereas those on mechanical ventilation was 48.1% and those with central line insertion was 52.6%. This study revealed that in Conclusion: enterococcal infections, hospital stay of >7 days, mechanical ventilation and central line insertion are signicantly associated with mortality.