Urinary tract infection caused by Enterococcus isolates: aetiology and antimicrobial resistance patterns

Area of Science:

• Microbiology
• Infectious Diseases
• Clinical Pharmacy

Background:

• Enterococcus species, particularly Enterococcus faecalis and Enterococcus faecium, are significant causes of hospital-acquired infections.
• Antimicrobial resistance in enterococci poses a major threat to patient care, necessitating ongoing surveillance.

Purpose of the Study:

• To analyze antimicrobial resistance patterns of Enterococcus faecalis and Enterococcus faecium isolated from inpatient urine samples between 2010 and 2013.
• To identify trends in resistance to key antimicrobial agents and high-level gentamicin resistance.

Main Methods:

• Retrospective analysis of clinical isolates of Enterococcus faecalis and Enterococcus faecium from urine samples.
• Evaluation of resistance profiles against ampicillin, nitrofurantoin, ciprofloxacin, high-level gentamicin, vancomycin, and linezolid.

Main Results:

• Enterococcus faecium isolates demonstrated significantly higher resistance to ampicillin, nitrofurantoin, and ciprofloxacin compared to Enterococcus faecalis.
• Both species exhibited high-level gentamicin resistance. Vancomycin-resistant enterococci (VRE) rates were higher in E. faecium, with an observed increase in VRE E. faecalis isolates over the study period.
• Resistance to linezolid and vancomycin remained below 30.2% and 20.3%, respectively, in both species. High rates of multidrug resistance (MDR) were noted.

Conclusions:

• Significant antimicrobial resistance, including MDR and VRE, is prevalent in Enterococcus species from inpatients.
• Clinicians must promote rational antibiotic use to mitigate the emergence and spread of resistant strains.
• Continuous monitoring of resistance trends is crucial for effective infection control and treatment strategies.