PREVALENCE OF VANCOMYCIN-RESISTANT ENTEROCOCCUS ISOLATED FROM CLINICAL SPECIMENS AT TERTIARY CARE HOSPITAL
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Abstract
Introduction: Vancomycin-resistant enterococci (VRE) has been recognized as a serious healthcare problem in recent times. Understanding the exact prevalence rate, and virulence factors among enterococci isolated from various clinical specimens is essential for controlling the spread of bacterial resistance and for epidemiological surveillance within the local healthcare settings. So, this study was performed to find out the prevalence of VRE and related risk factors among clinical specimens in the institute.
Material & Methods: This study was carried out on enterococci isolated from clinical specimens sent to the microbiology laboratory of the institute e.g. blood, urine, pus, wound discharge, CSF, and other body fluids (pleural and peritoneal). Direct microscopic examination was done using wet film for urine specimens and Gram stain for other specimens like pus and body fluids, looking for leukocytes and bacterial cells.
Results: Maximum isolates (70.59%) had shown VanA type resistance with high-level vancomycin resistance (MIC >256 µg/mL) while 17.65% of VRE isolates expressed VanB phenotype having moderate to high-level resistance to vancomycin and sensitive to teicoplanin. The rate of VRE infection was found to be significantly higher among patients who underwent surgical intervention. Among hospital-related risk factors, hospital stay(≥48hrs), ventilation, central venous catheterization, and admission to ICU were significantly associated with VRE infection. (p value<0.05). Conclusion: With a steady worldwide spread VRE can be expected as a major challenge to healthcare authorities in upcoming years. A multi-disciplinary approach is urgently needed including regular surveillance for the local epidemiology, early detection, and management, especially in the face of high-risk settings.
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Babita Kumari Fageria
Assistant Professor, Microbiology, National Institute of Medical Sciences & Research, Jaipur, Rajasthan
Ravindra Kashinath Khadse
Associate Professor, Microbiology, Indira Gandhi Government Medical College, Central Avenue, Nagpur
Sharmila Sanjay Raut
Professor and Head, Dept of Microbiology, Government Medical College, Akola