IJCRR - 6(3), February, 2014
Pages: 16-21
HIGH LEVEL AMINOGLYCOSIDE RESISTANT ENTEROCOCCUS SPECIES : A STUDY
Author: Niharika Lall, Silpi Basak
Category: Healthcare
[Download PDF]
Abstract:
Background and Objectives: The emergence of Enterococcus species as a causative agent of Health care Associated Infections, poses therapeutic challenge to clinicians. Enterococci are well equipped with intrinsic resistance to multiple antibiotics. Acquired resistance to commonly used antibiotics such as Penicillin, Aminoglycoside and Vancomycin have made the situation even worse. Detection of High Level Aminoglycoside Resistance (HLAR) in Enterococcus species can predict the loss of synergy between cell wall active antimicrobial agents and Aminoglycosides. Hence, the present study was undertaken to detect the incidence of High level Aminoglycoside Resistant (HLAR) Enterococcus species isolated in a rural hospital and to study their antibiotic susceptibility profile. . Method: HLAR in Enterococcus species was detected by disk diffusion test using High level Streptomycin (HLS - 300 μg) disk and High level Gentamicin (HLG - 120 μg) disk and Agar dilution method as per CLSI guidelines. High Level Gentamicin Resistance (HLGR) was also confirmed by HiMedia Ezy MIC Strip. Antibiotic sensitivity test was done by Kirby Bauer Disc diffusion method as per CLSI guidelines. Result: Out of total 190 Enterococcus species isolated from different clinical samples, High Level Aminoglycoside Resistance was detected in 115 (60.5%) Enterococcus strains. Amongst 115 HLAR Enterococcus strains, 59 (51.4%) were E. faecalis and 56 (48.6%) were E. faecium. Conclusion: We hereby conclude that Enterococcus strains, isolated from different clinical specimens must be screened routinely for HLAR (High Level Aminoglycoside Resistance) by all Clinical Microbiology Laboratories to improve the therapeutic outcome.
Keywords: Enterococci, High Level Aminoglycoside Resistant (HLAR), Multi-drug resistant.
Citation:
Niharika Lall, Silpi Basak. HIGH LEVEL AMINOGLYCOSIDE RESISTANT ENTEROCOCCUS SPECIES : A STUDY International Journal of Current Research and Review. 6(3), February, 16-21
References:
REFERENCES
1. Tendulkar PM, Baghdayan AS, Shankar N. Pathogenic Enterococci: New developments in the 21st Century. Cell Mol Life Sci. 2003;60: 2622-2636.
2. Washington Winn, Jr., Stephen Allen, William Janda et al.Koneman’s Color Atlas and Textbook of Diagnostic Microbiology. 6th ed. Philadelphia: Lippincott Williams And Wilkins; 2006. Chapter 13, Gram –Positive Cocci Part II: Streptococci, Enterococci, and the “Streptococcus-Like” Bacteria; p.672-764.
3. Herman, D. J., and Gerding DN. Screening and treatment of infections caused by resistant enterococci. Antimicrob. Agents Chemother. 1991; 35: 215–219.
4. Papaparaskevas J, Vatapoulos A, Tassios PT, Avlami A, Legakis NJ and Kalapothaki V. Diversity among high-level aminoglycosideresistant enterococci. Journal of Antimicrobial Chemotherapy 2000;45: 277-283.
5. Facklam RR, Collins MD. Identification of Enterococcus species isolated from human infections by conventional test scheme. J Clin Microbiol. 1989;24: 731-734.
6. Clinical and Laboratory Standards Institute (2012) Performance standards for antimicrobial susceptibility testing: 22th informational supplement. CLSI document M100-S22. Clinical Laboratory Standards Institute, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087-1898 USA.
7. Adhikari L. High-level Aminoglycoside Resistance and Reduced Susceptibility to Vancomycin in Nosocomial Enterococci. J Glob Infect Dis. 2010; 2(3): 231–235.
8. Deshpande VR, Karmarkar MG, Mehta PR. Prevalence of multidrug-resistant enterococci in a tertiary care hospital in Mumbai, India. J Infect Dev Ctries. 2013;7 (2): 155-158.
9. Mendiratta DK, Kaur H, Deotale V, Thamke DC, Narang R, Narang P. Status of High level aminoglycoside resistant Enterococcus faecium and Enterococcus faecalis in a rural hospital of Central India. Indian Journal of Medical Microbiology. 2008; 26 (4): 369-71.
10. Vinodkumar C. S, Srinivasa H., Basavarajappa K. G., Geethalakshmi S., Bandekar N. Isolation of bacteriophages to multi-drug resistant Enterococci obtained from diabetic foot: A novel antimicrobial agent waiting in the shelf? Indian Journal of Pathology and Microbiology. 2011; 54 ( 1 ):90-95.
11. Park K. Park’s Textbook of Preventive and Social Medicine. 22nd ed. Jabalpur: Banarsidas Bhanot; 2013. Chapter 19, Health information and basic medical statistics: p.782-796.
12. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, Harbarth S, Hindler JF, Kahlmeter G, Olsson-Liljequist B, Paterson DL, Rice LB, Stelling J, Struelens MJ, Vatopoulos A, Weber JT, Monnet DL. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012; 18(3):268-81.
13. Marothi YA, Agnihotri H, Dubey D. Enterococcal resistance:an overview. Indian Journal of Medical Microbiology. 2005; 23(4):214-219.
|