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Significance of vancomycin resistant enterococci from urinary specimens at a tertiary care centre in northern India

Neelam Taneja1, Phulan Rani, Rekha Emmanuel

  • 1Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research Chandigarh, India. drneelampgi@yahoo.com

The Indian Journal of Medical Research
|April 2, 2004
PubMed
Abstract

Insights

Vancomycin-resistant enterococci (VRE) were identified in Indian urine samples, highlighting a potential emerging threat. Early screening for VRE in suspected urinary tract infections is crucial for patient management.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Clinical Laboratory Science

Background:

  • Limited data exists on vancomycin resistance in enterococci within India.
  • Enterococci are a significant cause of hospital-acquired infections.
  • Vancomycin resistance in enterococci (VRE) poses a major therapeutic challenge.

Purpose of the Study:

  • To screen enterococci isolated from urine specimens for vancomycin resistance.
  • To determine the prevalence and characteristics of vancomycin-resistant enterococci (VRE) in an Indian setting.
  • To assess the clinical implications of VRE in patients with urinary tract infections.

Main Methods:

  • Agar screen method and E-test were used to detect vancomycin resistance.
  • Minimum inhibitory concentration (MIC) was determined by E-test and agar dilution.
  • Retrospective review of clinical data for patients with VRE isolates.

Main Results:

  • Eight vancomycin-resistant enterococci (VRE) isolates were identified, including Enterococcus faecium, E. faecalis, E. casseliflavus, and E. pseudoavium.
  • Minimum inhibitory concentrations (MICs) ranged from 8 to 32 µg/ml.
  • Five patients had nosocomial urinary tract infections (UTIs), two had community-acquired UTIs, and one had asymptomatic bacteriuria. Two patients with nosocomial UTI and sepsis died despite vancomycin treatment.

Conclusions:

  • The isolation of VRE in India, though not highly frequent, suggests a potential emerging public health concern.
  • Screening for vancomycin resistance is recommended for all patients with suspected UTIs and significant bacterial counts.
  • Early detection and management are critical to combat the spread of VRE.

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