Antibiotic susceptibility pattern of Enterococcus isolates in a five year period at a tertiary care hospital

Abstract

Aim: Enterococci are present as a part of the normal gut flora which can cause many community- and hospital-acquired infections. It is essential to determine the antibiotic resistance profile in treatment of Enterococcus spp. In this study we aimed to determine the sub-species of Enterococcus spp and their antibiotic resistance profiles isolated from a tertiary hospital in a five-year period.

Methods: The antibiotic resistance profiles of 2995 Enterococcus spp isolated from various clinical specimens of patients between January 2014 and December 2018 were reviewed in this retrospective cohort study. 

Results: Ampicillin resistance was very low (5.6%) in E. faecalis, but it was very high in E. faecium (91.8%). High level gentamycin, high level streptomycin and levofloxacin resistances were very high in all Enterococcus species and especially in E. faecium. Linezolid, tigecycline or daptomycin resistance was not determined in any Enterococcus isolates. Nitrofurantoin resistance (61.9%) and parenteral penicillin resistance (82.4%) were also very high in E. faecium isolates. Teicoplanin resistance was very low in E.faecalis (1.5%) isolates but approximately half (44.9%) of the E. faecium isolates were resistant to Teicoplanin. Vancomycin resistance was determined in 1.5% of E.faecalis isolates and in 45.5% of E. faecium isolates. 

Conclusion: In conclusion, we determined high resistance rates to many antibiotics in both E. faecalis and E. faecium isolates. Tigecyclin, linezolid and daptomycin resistance was not determined in any Enteroccus isolates. Vancomycin resistance was determined in 1.5% of E. faecalis isolates and in 45.5% of E. faecium isolates. This high rate of vancomycin resistance should be taken into account and studies should be conducted to eliminate this resistance.

Keywords

• Enterococcus faecalis,Enterococcus faecium,Enterecoccus antibiotic resistance,Enterococcal infection

Üçüncü basamak bir hastanede beş yıllık bir sürede izole edilen Enterococcus izolatlarında antibiyotik duyarlılık profili

Öz

Amaç: Enterokoklar, normal bağırsak florasının bir üyesi olup, birçok toplum- ve hastane- kökenli enfeksiyona neden olabilmektedirler. Enterococcus spp. tedavisinde antibiyotik direnç profilinin belirlenmesi son derece önemlidir. Bu çalışmanın amacı, beş yıllık bir süre içerisinde üçüncü basamak bir hastaneden izole edilen Enterococcus spp. alt tiplerini ve antibiyotik direnç profillerini belirlemektir.

Yöntemler: Ocak 2014-Aralık 2018 tarihleri arasında çeşitli klinik örneklerden izole edilen 2995 Enterococcus spp. nin antibiyotik direnç profilleri bu retrospektif kohort çalışmada incelendi.

Bulgular: E. faecalis 'te ampisilin direnci çok düşük (%5,6) iken E. faecium 'da (%91,8) çok yüksekti. Yüksek düzey gentamisin, yüksek düzey streptomisin ve levofloksasin dirençleri tüm Enterococcus türlerinde ve özellikle E. faecium 'da çok yüksekdi. Enterococcus izolatlarında linezolid, tigesiklin veya daptomisin direnci saptanmadı. E. faecium izolatlarında nitrofurantoin (%61,9) ve parenteral penisilin direnci (%82,4) de yüksekti. E. faecalis'te (%1,5) teicoplanin direnci çok düşüktü, ancak E. faecium izolatlarının yaklaşık yarısı (%44,9) teicoplanine dirençliydi. Vankomisin direnci, E. faecalis izolatlarının %1,5'inde, ancak E. faecium izolatlarının %45.5'inde belirlenmiştir.

Sonuç: Sonuç olarak, hem E. faecalis hem de E. faecium izolatlarında birçok antibiyotiğe yüksek direnç oranları belirledik. Enteroccus izolatlarında tigesiklin, linezolid ve daptomisin direnci yoktu. Vankomisin direnci, E. faecalis izolatlarının %1,5'inde, ancak E. faecium izolatlarının %45,5'inde belirlenmiştir. Bu yüksek vankomisin direnci oranı göz önünde bulundurularak bu direnci ortadan kaldırmak için çalışmalar yapılmalıdır.

Anahtar Kelimeler

• Enterococcus faecalis,Enterococcus faecium,Enterecoccus antibiyotik direnci,Enterokok enfeksiyonu

Kaynakça

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