Clinico-epidemiological profile and high-level aminoglycoside resistance in enterococcal septicemia from a tertiary care hospital in east Delhi

BACKGROUND: Emergence of high-level aminoglycoside and glycopeptide resistance has significantly contributed to the mortality, particularly in serious enterococcal infections. OBJECTIVES: This study was aimed to determine the prevalence of high-level gentamicin resistance (HLGR), high-level streptomycin resistance (HLSR) and vancomycin resistance in enterococcal isolates recovered from patients with bacteremia. MATERIALS AND METHODS: A total of 110 blood culture isolates of enterococci were recovered from septicemic patients. Routine antibiotic susceptibility testing was performed and screening for ampilcillin, high-level aminoglycoside resistance (HLAR) and high-level vancomycin resistance was done by agar screen method. RESULTS: Out of 110 isolates, Enterococcus faecium accounted for 53% of these isolates, followed by Enterococcus fecalis (33%), Enterococcus casseliflavus (8%), Enterococcus raffinosus (4%) and Enterococcus dispar (2%). Resistance to ampicillin, HLGR, HLSR and HLAR was detected in 58%, 62%, 58% and 54% of the isolates, respectively. No isolate was resistant to vancomycin. CONCLUSION: This study illustrates the high prevalence of HLAR in enterococci from patients with septicemia in our region, which emphasizes the need to predict synergy between beta-lactams and aminoglycosides for management of enterococcal infections.