Enterococcal bacteraemia in a tertiary care hospital of North India

A prospective study was conducted to determine clinical and bacteriologic features and antibiotic resistance pattern of enterococci isolated from cases of bacteraemia over a 7-month period. A total of 103 patients were identified during the study period whose blood culture was found to be positive for Enterococcus species. Bacteraemia was nosocomially acquired in 100 patients and community acquired in three. Enterococcus faecalis was isolated in 99 patients and E faecium in four. Bacteraemia was polymicrobial in 34 patients. Majority of patients had serious underlying diseases and were on prior therapy with cephalosporins. A source of bacteraemia was found in 59 patients (57.2%); intravascular catheters being the most common identifiable source. Overall mortality rate was 5.8%. High level aminoglycoside resistance was found in 76 (73.8%) of the enterococcal isolates. Vancomycin resistance was not found in any of the isolates. Bacteraemia due to enterococci is emerging as a significant clinical problem in hospital settings. A watchful vigilance is therefore required as regards their antibiotic resistance pattern particularly high level aminoglycoside resistance and vancomycin resistance. In addition hospital practices like prolonged use of in situ catheters and inadvertent antibiotic usage need to be minimised.