Antimicrobial Resistance of Enterococcal Blood Isolates at a Pediatric Care Hospital in India

Abstract

Enterococci are one of the leading causes of nosocomial infections. In recent years, enterococci have become increasingly resistant to a wide range of antimicrobial agents. From April to October 2001, a study was conducted to speciate and determine the antimicrobial susceptibility of 50 isolates of enterococci from bacteremic children. These isolates were tested for antimicrobial susceptibility to the commonly used antibiotics. Screening for vancomycin resistance was done by the agar screen method, and the results were confirmed by determining the minimum inhibitory concentration (MIC) using the agar dilution method. It was observed that 33 isolates were Enterococcus faecium, followed by E. faecalis (10), E. durans (4), and E. dispar (3). Seventy-two percent of strains were resistant to ampicillin, 46% to amoxicillin + clavulanic acid, 72% to ciprofloxacin, 54% to doxycyclin, and 74% to erythromycin. Sixty-six percent of isolates showed high-level gentamicin resistance and 42% showed high-level streptomycin resistance. Four strains showed raised MIC to vancomycin (8 μg/ml). It was concluded that multidrug resistant E. faecium is emerging as an important agent of bacteremia in children.