DESCRIPTIVE STUDY OF ENTEROCOCCAL SPECIES WITH THEIR ANTIBIOTIC STEWARDSHIP IN TERTIARY CARE HOSPITAL
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 1
Abstract
BACKGROUND Objectives of this study were 1. Isolation and speciation of enterococci from urine, pus sample, blood and other body fluids. 2. To identify the species of enterococci mostly isolated in ICU and non-ICU samples. 3. To know antibiotic susceptibility pattern of the various isolates. MATERIALS AND METHODS 1. Samples such as blood, urine, pus, respiratory samples were collected from patients attending as outpatients and also from different clinical department wards and intensive care units by observing standard specimen collection procedure and aseptic conditions. 2. Identification of Enterococcus species is based on routine bacteriological culture methods and biochemical tests. 3. Antibiotic susceptibility testing was performed with Ampicillin, Penicillin, Levofloxacin, Nitrofurantoin, HL Gentamycin, HL Streptomycin and Teicoplanin with the disc diffusion method (modified Kirby-Bauer method) using Mueller-Hinton agar. 4. Vancomycin Sensitivity test was done with Enterococcus species by E Test Strip using Mueller-Hinton agar. MIC determination paper strip which is coated with Vancomycin in a concentration gradient manner, capable of showing MICs in the range of 0.016 mcg/ml to 256 mcg/ml, on testing against the Enterococcus organism. RESULTS 1. Out of 97 samples isolated, 42% were from Enterococcus faecalis, 41% were from Enterococcus faecium, 3% were from Enterococcus avium, 1% from Enterococcus gallinarum and 11% were from other Enterococcus Species. 2. Enterococcus faecalis showed high sensitivity to Ampicillin, Penicillin, Levofloxacin, Nitrofurantoin, Vancomycin and Teicoplanin. Enterococcus faecium and all other species showed high sensitivity to Vancomycin and Teicoplanin only. 3. Enterococcus faecalis were most commonly isolated in ICU and Surgery post-operative ward (IP). Enterococcus faecium were most commonly isolated in OPD, Medical-, Paediatrics- and OG-Wards (IP). 4. Vancomycin and Teicoplanin were most commonly sensitive in OP, Medicine, Paediatrics, & O&G Wards. Ampicillin, Penicillin and Levofloxacin, were most commonly sensitive in Surgery& ICU Wards. CONCLUSION Infection control measures like hand washing, ideal disinfectant usage, and strict antibiotic policy reduces Vancomycin resistance to zero Level in our tertiary care hospital. Enterococcal faecium slowly increasing with most of the antibiotics should be continuously monitored. ICU and surgical ward need more attention to bring down the bugs with antibiotic resistance.
Authors and Affiliations
Ram Murugan Navaneetha Krishnan, Senthil Kumar Jayakumar Jayaraj
Keywords
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- EP ID EP553023
- DOI 10.14260/jemds/2019/9
- Views 92
- Downloads 0
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