Published
2024-11-22
Section
Articles
How to Cite
Antimicrobial Resistance and Prevalence of Enterococcus faecium and Enterococcus faecalis in a Tertiary Care Hospital in Dhaka, Bangladesh
Nisat Sultana
Nisat Sultana, Department of Microbiology, Stemz Health Care Limited, Bangladesh, nisat1995liza@gmail.com
Md. SujonAli
Md. Sujon Ali, Department of Medical Biotechnology, University of Technology Sydney (UTS), Australia, msujonali07@gmail.com
Sayma Sultana
Sayma Sultana, Department of Global Health and Human Service Administration, Fairleigh Dickinson University, Canada, moonsultana13@gmail.com
Md. AshiqurRahman
Md. Ashiqur Rahman, Department of Laboratory Medicine, Novus Clinical Research Services Limited, Dhaka, Bangladesh, ararashiqur@gmail.com
Sadia Islam
Sadia Islam, Department of Laboratory Medicine, Bangladesh Specialized Hospital PLC, Bangladesh, sadia.buhs.6700@gmail.com
Keywords: Enterococcus faecium; AMR; Enterococcus faecalis; Penicillin
Abstract
Enterococci, particularly Enterococcus faecium and Enterococcus faecalis, are prominent opportunistic pathogens in hospital settings, often linked to severe infections and increased morbidity and mortality. The rise in antimicrobial resistance, notably high-level aminoglycoside-resistant and vancomycin-resistant enterococci, poses significant treatment challenges. Objective: To assess the prevalence of Enterococcus infections and evaluate their antibiotic susceptibility patterns, with a focus on understanding resistance trends and their association with patient demographics and specimen types. Methodology: A hospital-based cross-sectional study was conducted at a tertiary care hospital over one year. Clinical samples, including blood, urine, and pus, were collected and processed using standard microbiological techniques. Identification of Enterococcus species was performed using biochemical tests, and antibiotic susceptibility was determined using the modified Kirby-Bauer disc diffusion method. Data were analyzed using SPSS version 22.0, and statistical associations were examined for significance. Results: Out of 1500 clinical samples, 147 were positive for Enterococcus species, with Enterococcus faecium (58.3%) and Enterococcus faecalis (31.7%) being the most prevalent. The study found high resistance rates in E. faecium to penicillin (40.0%) and ciprofloxacin (60.0%), while E. faecalis exhibited lower resistance levels. Resistance to linezolid (0.9%) and vancomycin (6.2%) was relatively low. Significant associations were observed between age groups, specimen types, and antibiotic resistance patterns. Younger patients (16-36 years) showed higher resistance levels compared to older groups. Conclusion: The study reveals a high prevalence of Enterococcus faecium with significant antibiotic resistance, emphasizing the need for ongoing surveillance and effective antimicrobial stewardship. An inverse relationship was observed between prevalence and resistance levels. Further research into resistance mechanisms and patient demographics is essential to address antimicrobial resistance in hospital settings.
References
1.Cetinkaya Y, Falk P, Mayhall CG. Vancomycin-resistant enterococci. Clinical microbiology reviews. 2000 Oct 1;13(4):686-707.
2.NI AH, Huycke MM. Enterococcal disease, epidemiology, and implications for treatment.
3.Garsin DA, Frank KL, Silanpää J, Ausubel FM, Hartke A, Shankar N, Murray BE. Pathogenesis and models of enterococcal infection. Enterococci: from commensals to leading causes of drug resistant infection [internet]. 2014 Feb 7.
4.Lebreton F, Willems RJ, Gilmore MS. Enterococcus diversity, origins in nature, and gut colonization. Enterococci: from commensals to leading causes of drug resistant infection. 2014 Feb 2.
5.Schouten MA, Hoogkamp-Korstanje JA, Meis JF, Voss A, European VRE Study Group. Prevalence of vancomycin-resistant enterococci in Europe. European Journal of Clinical Microbiology and Infectious Diseases. 2000 Dec;19:816-22.
6.Miller WR, Munita JM, Arias CA. Mechanisms of antibiotic resistance in enterococci. Expert review of anti-infective therapy. 2014 Oct 1;12(10):1221-36.
7.Verfuerth S, Geary J. Infections of the immunocompromised host. leukemia. 2002;99:1873-4.
8.Patel R. Clinical impact of vancomycin-resistant enterococci. Journal of Antimicrobial Chemotherapy. 2003 Jun 1;51(suppl_3):iii13-21.
9.Sattari-Maraji A, Jabalameli F, Node Farahani N, Beigverdi R, Emaneini M. Antimicrobial resistance pattern, virulence determinants and molecular analysis of Enterococcus faecium isolated from children infections in Iran. BMC microbiology. 2019 Dec;19:1-8.
10.Helmy YA, Taha-Abdelaziz K, Hawwas HA, Ghosh S, AlKafaas SS, Moawad MM, Saied EM, Kassem II, Mawad AM. Antimicrobial resistance and recent alternatives to antibiotics for the control of bacterial pathogens with an emphasis on foodborne pathogens. Antibiotics. 2023 Jan 30;12(2):274.
11.Karlowsky JA, Kelly LJ, Thornsberry C, Jones ME, Sahm DF. Trends in antimicrobial resistance among urinary tract infection isolates of Escherichia coli from female outpatients in the United States. Antimicrobial agents and chemotherapy. 2002 Aug;46(8):2540-5.
12.Boccella M, Santella B, Pagliano P, De Filippis A, Casolaro V, Galdiero M, Borrelli A, Capunzo M, Boccia G, Franci G. Prevalence and antimicrobial resistance of Enterococcus species: a retrospective cohort study in Italy. Antibiotics. 2021 Dec 19;10(12):1552.
13.Ben Sallem R, Klibi N, Klibi A, Ben Said L, Dziri R, Boudabous A, Torres C, Ben Slama K. Antibiotic resistance and virulence of enterococci isolates from healthy humans in Tunisia. Annals of Microbiology. 2016 Jun;66:717-25.
14.Islam S, Aziz ZT, Rahman MA, Rahaman S, Hossain MB. Characterization of the microorganisms of human pus samples-a tertiary care hospital based study. Molecular Mechanism Research. 2024 Jul 2;2(1):6171-.
15.SujonAli M, AshiqurRahman M, Islam S, Rahaman S, Sakib KM, Al-AminHossen M, JahanRimu A. Prevalence and Antibiotic Susceptibility Pattern of Enterococcus Spp. Isolated from Urine Samples. Molecular Mechanism Research. 2023 Dec 13;1(1):134-.