Affiliation:
1. Assistant Professor, Department of Microbiology, SMS Medical College, Jaipur.
2. Sr.Professor, Department of Microbiology, SMS Medical College, Jaipur.
Abstract
Introduction: The emergence of High Level Aminoglycoside Resistance (Resistant to Gentamycin and
Streptomycin) and Vancomycin Resistant Enterococci among Indoor and Intensive Care Unit admitted
patient presents a serious challenge for clinicians. Objective: To determine Enterococcal burden in blood and urine specimens
and to detect the prevalence of High Level Aminoglycoside Resistance and Vancomycin Resistant Enterococci. Material &
Methods: One hundred ten Enterococci were isolated from blood and urine samples and processed according to standard
laboratory protocol. Species identication and sensitivity was done using the VITEK 2 automated system (Biomerieux France)
with the cards GPID and AST 67 respectively. Results: Out of 110 Enterococci isolates, 36 were from blood and 74 from urine
were detected. Different Species isolated were Enterococcal faecium (59%), Enterococcal faecalis (34%), Enterococcal
rafnosus (2.7%), Enterococcal gallinarum (1.8%), Enterococcal casseliavus (0.9%) and Enterococcal duran (0.9%).Out of 36
blood isolates, 14 (38%) were found to be both High Level Gentamycin Resistant (HLGR) & High Level Streptomycin Resistant
(HLSR), 10 (27%) were only HLGR and 8 (22%) were only HLSR. 20 strain (55%) of Enterococcus species isolated in blood were
VRE. All VRE strains were found to be resistant to both aminoglycosides ( HLAR).Among the 74 urinary isolates, 24 (34%) were
found to be both HLGR & HLSR, only HLGR was observed in 20 (27%) and HLSR was observed in 11 (14%) isolates. 24 strains
(34%) of Enterococcus species were found to be vancomycin resistant in urine. 23 strains out of 24 were resistant to high level of
aminoglycosides. Conclusion: The prevalence of HLAR and VRE is very high among Enterococcus specimens from indoor/
intensive care unit patients. Early species identication and antibiotic sensitivity result can help in better clinical outcome.
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