De novo daptomycin non-susceptible enterococci causing urinary tract infection: a study from north India
Journal Title: IP International Journal of Medical Microbiology and Tropical Diseases - Year 2018, Vol 4, Issue 1
Abstract
Introduction Daptomycin is a bactericidal agent active against vancomycin resistant enterococci VRE which are emergent nosocomial uropathogens There is limited data available on daptomycin nonsusceptible enterococci DNSE in India Herein we describe the emergence of de novo DNSE causing urinary tract infections UTI from IndiaMaterials and Methods We prospectively screened consecutive enterococci n140 grown in significant numbers ge105cfuml from urine cultures in hospitalized patients n12434 over 6 months Isolates with daptomycin minimum inhibitory concentration MIC gt4microgml by Etest and no history of daptomycin exposure were defined as DNSE Colonization and symptomatic UTI was defined as per the Centre for Disease Control and Prevention guidelinesResults Prevalence of DNSE was 121 17140 and all were E faecium In 6 cases 352 DNSE isolates were colonizers while 116471 were from UTI cases Urosepsis occurred in 4 cases of which 3 died History of immunocompromise recent urogenital surgery and indwelling perurethral catheter were present in 47 588 and 647 cases respectively Exposure to third generation cephalosporin and metronidazole was seen in nine 529 and 3 1765 cases respectively while one patient each had vancomycin and teicoplanin exposure Daptomycin MIC range was 6 to gt256 microgml Resistance to ciproflocaxin amoxicillin high level gentamicin tetracycline nitrofurantoin and vancomycin was seen in 100 941 882 529 411 and 235 respectively All DNSE were susceptible to linezolidConclusions A high prevalence of DNSE warrants further case control studies molecular and epidemiological studies to elucidate the risk factors molecular mechanisms of resistance and epidemiological origin of these isolatesKeywords De novo Daptomycin Enterococci UTI India
Authors and Affiliations
Neelam Taneja, Shubha Garg, Shreya Singh, Suma B Appannanavar, Balvinder Mohan
Keywords
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- EP ID EP485834
- DOI 10.18231/2455-6807.2018.0008
- Views 72
- Downloads 0
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