Correlation Between Surgical Ward Stay and High Gentamicin Resistance of Enterococcus faecalis: A Retrospective Study

Background: The increasing antimicrobial resistance of Enterococcus faecalis, particularly high-level aminoglycoside resistance, represents a growing challenge in the management of hospital-acquired infections. Surgical wards are considered potential environments for the dissemination of resistant strains due to frequent antibiotic exposure and invasive procedures. Methods: The aim of this study was to evaluate the association between hospitalization in a general surgery ward and the detection of Enterococcus faecalis isolates with high-level gentamicin resistance (HLGR). A retrospective observational study was conducted using microbiological and clinical data from a single medical center in Poland between 2022 and 2024. Only the first isolate per patient was included in the analysis. HLGR was detected using gentamicin at a screening concentration of 500 µg/mL. Associations between clinical variables and HLGR were assessed using univariate analysis and multivariable logistic regression, including hospitalization in a general surgery ward, age, prior hospitalization, and antibiotic therapy within 90 days. Results: HLGR was identified in a substantial proportion of Enterococcus faecalis isolates. Hospitalization in a general surgery ward was significantly associated with HLGR detection. In multivariable analysis, surgical ward hospitalization remained independently associated with HLGR after adjustment for other variables. Prior antibiotic exposure demonstrated the strongest association with HLGR. Conclusions: Hospitalization in a general surgery ward was associated with an increased likelihood of detecting Enterococcus faecalis isolates with high-level gentamicin resistance. These findings support the importance of antimicrobial stewardship and infection control strategies in surgical settings to limit the spread of resistant enterococcal strains.