Open AccessInfection dynamics of vancomycin and inducible clindamycin resistant Enterococcus faecalis in an Indian teaching hospital
Author(s) -
Debasmita Dubey,
Rabindra N. Padhy
Publication year - 2015
Publication title -
asian pacific journal of tropical disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.208
H-Index - 33
ISSN - 2222-1808
DOI - 10.1016/s2222-1808(15)60873-8
Subject(s) - clindamycin , enterococcus faecalis , vancomycin , linezolid , microbiology and biotechnology , erythromycin , ampicillin , agar plate , enterococcus , agar , antibiotics , medicine , biology , bacteria , staphylococcus aureus , genetics
Objective: To do surveillance for vancomycin and inducible clindamycin resistance of\udEnterococcus faecalis (E. faecalis), a Gram-positive bacterium in a teaching hospital.\udMethods: E. faecalis strains isolated from clinical samples were screened for vancomycin\udand inducible clindamycin resistance, i.e., D-test positivity, using vancomycin screen agar\udand blood agar plates, respectively. For the D-test screening, erythromycin resistant (Er-r) and\udclindamycin sensitive (Cd-s) strain were used.\udResults: Of 265 isolated E. faecalis strains, 159 (60%) were vancomycin resistant\udEnterococcus (VRE) and 106 were vancomycin sensitive Enterococcus (VSE). Of 265 strains,\ud42 were constitutively resistant to clindamycin and erythromycin and of 148 Er-r and Cd-s\udstrains, 87 (32.83%) had D-test positivity, while the rest 61 strains were D-test negatives.\udD-test results examined with 6 hospital factors as bivalents, only 2 factors, the VSE/VRE and\udthe presence/absence of prior antibiotic use > 90 days bivalent were statistically significant.\udA VRE strain with D-test positivity would be picked up 0.570 2 times more frequently than\uda strain with VSE and D-test positivity. Also, patients with prior antibiotic use > 90 days had\ud3.737 5 times more chance of picking up D-test positive strains than patients without any\udprior antibiotic use. Resistance pattern of E. faecalis strains to individual 14 antibiotics were\udrecorded; the maximum values of resistance were against ampicillin 10 μg/disc and linezolid\ud30 μg/disc. Student’s t-test for hospital acquired and community acquired data revealed that\uddrug resistant strains were equally prevalent in both sources.\udConclusions: Prevalence of 60% VRE in both hospital and adjoining community creates\udconsternation. In total 87 (32.83%) strains had D-test positivity; patients who had used\udantibiotics within the last 90 days have got an ample chance of picking of D-test positive\udE. faecalis. D-test protocol should be followed with clinical samples in hospitals for Grampositive bacteria