Linezolid and Vancomycin Resistant Enterococci: A Therapeutic Problem
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 8
Abstract
Introduction: Enterococci are recognized as opportunistic pathogens, as well as commensals in both humans and animals. They are an important cause of nosocomial infections, difficult to treat, as the organism have intrinsic and acquired resistance to many antibiotics. Aim: To isolate and identify clinically relevant Enterococcus up to species level from all the clinical samples processed in the microbiology laboratory and also to study their resistance pattern. Materials and Methods: A prospective study was carried out for a period of one year from May 2014 to April 2015 at the Department of Microbiology, Subharti Medical College, Meerut, Uttar Pradesh, India. A total of 200 isolates of Enterococcus species from 15342 clinical samples obtained from IPD/OPD patients irrespective of age, having suspicion of bacterial infection were processed in the microbiology laboratory. Identification was done with standard biochemical methods. Antibiotic susceptibility testing was done on Muller Hilton agar plate by Kirby Bauer disc diffusion method. High-Level Gentamycin Resistance (HLGR) and High-Level Streptomycin Resistance (HLSR) were further confirmed by Agar dilution method and Broth microdilution method. Vancomycin and linezolid resistance was further confirmed by Agar dilution method and MIC was calculated by using VITEK 2, Biomerieux. All methodology was followed as per Clinical and Laboratory Standards Institute (CLSI) M100-S 24, 2014 guidelines. Results: E. faecalis (n=169, 84.5%) was the predominant species isolated, followed by E. faecium (n=27, 13.5%) and E. casseliflavus (n=4, 2%). A total of 25 (12.5%) isolates were HLGR, 13 (6.5%) isolates were HLSR and 62 (31%) isolates were HLGR+HLSR. Vancomycin resistance was found in 14 (7%) isolates of which 11 (78.5%) were Van A and 3 (21.4%) were Van B, detected phenotypically as per relative MIC of vancomycin and teicoplanin. Linezolid resistance was seen in 4 (2%) of isolates which were vancomycin as well as high-level gentamycin and high-level streptomycin resistant. Conclusion: Isolation of Enterococcus species resistant to most of the higher antibiotics like vancomycin and linezolid, with high prevalence of High-Level Aminoglycoside Resistance (HLAR), from hospitalized patients is a major concern as such isolates have limited or no therapeutic option.
Authors and Affiliations
Garima Yadav, Bhaskar Thakuria, Molly Madan, Vivek Agwan, Anita Pandey
Keywords
Related Articles
- EP ID EP358339
- DOI 10.7860/JCDR/2017/27260.10474
- Views 78
- Downloads 0
Knee X-Ray in Short Stature: Helpful Indicator to Diagnose SHOX Deficiency
Images in Medicine
Diagnostic Approach to Viral Acute Encephalitis Syndrome (AES) in Paediatric Age Group: A Study from New Delhi
Introduction: Acute Encephalitis Syndrome has heralded the emergence of multiple virulent pathogens, which may result in severe morbidity and mortality. In India, encephalitis is not notified and there has been a dearth...
Estimation of Total Length of Femur from its Proximal and Distal Segmental Measurements of Disarticulated Femur Bones of Nepalese Population using Regression Equation Method
Introduction: Length of long bones is taken as an important contributor for estimating one of the four elements of forensic anthropology i.e., stature of the individual. Since physical characteristics of the individual d...
Radiotherapy in Phyllodes Tumour
Introduction: Phyllodes Tumour (PT) of the breast is a relatively rare breast neoplasm (<1%) with diverse range of pathology and biological behaviour. Aim: To describe the clinical course of PT and to define the role of...
Disorders Affecting Quality of Life During Pregnancy: A Qualitative Study
Introduction: Pregnancy is a special condition which results in unique physiological responses which is more than any other physiological event and it increase stress in women’s body. Information about the changes experi...