Antimicrobial Susceptibility Pattern of Enterococcus Species Isolated from Patients with Urinary Tract Infection

Abstract

Background: Enterococci are the most common cause of healthcare associated urinary tract infections. The frequency of isolation of enterococci from urinary tract of hospitalized patients has risen. Vancomycin resistant enterococci along with other multidrug resistant bacteria are the main concerns for physicians. Enterococci may also act as vehicle for spread of resistant genes. The objective of this study was to determine the antimicrobial susceptibility pattern of different enterococcal species isolated from urine samples. Material & Methods: This cross-sectional study was conducted at Department of Microbiology, Armed Forces Institute of Pathology, Rawalpindi. Hundred enterococcal isolates cultured from urinary specimens were processed from October 2011 to March 2012. In-vitro drug-susceptibility tests of enterococci isolated were performed on Mueller Hinton agar. Results: A total of 100 urine specimens yielding growth of enterococci were studied. Among these only 7 samples were from OPD, the rest were from different wards. The mean age was 55±24.58 (range 8-89) years. Sixty-six (66%) of the isolates were from males while 34(34%) from females. Enterococcus faecalis was isolated in 81(81%) cases while Enterococcus faecium in 19(19%). Regarding sensitivity, 100% isolates were susceptible to linezolid, 99% to teicoplanin, 97% to vancomycin, 88% to imipenem, 87% to co-amoxiclav, 81% to nitrofurantoin, 75% to ampicillin, whereas the susceptibility to ciprofloxacin and tetracycline was 42% and 38% respectively. Conclusion: Enterococci have emerged from being harmless commensals to versatile lethal pathogens. The rising antibiotics resistance is worrisome as the commonly used antibiotics for the treatment of nosocomial UTI are less effective.