Detection of High Level Aminoglycosides Resistant Entrococci In A Tertiary Care Hospital

BACKGROUND: Emergence of high-level aminoglycoside and glycopeptide resistance has significantly contributed to the mortality, particularly in serious enterococcal infections. High Level Aminoglycoside Resistance (HLAR) is related to the slow uptake or permeability of these agents. AIM: The present study was undertaken to determine HLAR pattern of enterococci in our hospital. METERIALS AND METHODS: This study was done in the Department of Microbiology, Meenakshi medical college, during the period of February 2012February 2013. A total of 52 enterococcal isolates were collected from various clinical samples and speciation was by a series of biochemical reactions as per standard protocol.. Antibiotic susceptibility testing was done by Kirby Bauer disc diffusion method and microbroth dilution method according to CLSI guidelines 2012. RESULT: In the present study majority of the Enterococcal isolates in our study were isolated from urine sample. Among the 52 isolates of enterococci E.faecalis was the predominant species. The highest percentage of antibiotic resistance was seen in Erythromycin followed by Ciprofloxacin, Tetracycline, Ampicillin and Vancomycin. The High level Gentamycin Resistance (HLGR) was 48.7% in E.faecalis and 54.6% in E.faecium & High Level Streptomycin Resistance (HLSR) was 34.1% in E.faecalis and 54.6% in E.faecium. 23 strains (17 E.faecalis and 6 E.faecium) showed resistance to High Level Gentamycin (HLG) in the concentration range of >500μg/ml. 17strains (12E.faecalis and 5 E.faecium) showed resistance to High Level streptomycin (HLS) at the range of >1000 μg/ml. CONCLUSION: This study emphasizes the need to screen for HLAR in patients suffering from enterococcal infections. Routine screening for high level aminoglycoside resistance is important to limit the spread of resistance and to have a surveillance programme.