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Antibiotic susceptibility pattern in clinical isolates of Enterococci at a tertiary care hospital

INTRODUCTION: Enterococci have emerged as leading causes of healthcare-associated infections globally. Glycopeptide-resistant Enterococci have become a major threat to hospitalised patients, causing outbreaks that increase morbidity, mortality and healthcare-associated costs. MATERIALS AND METHODS: All samples were inoculated on appropriate culture plates. Confirmation was done by performing Gram's stain, catalase test and bile-esculin hydrolysis. Antibiotic susceptibility testing was performed using modified Kirby–Bauer's disk diffusion method. Vancomycin resistance in Enterococci was detected by performing Epsilometer test on Mueller–Hinton agar, and results were interpreted as per CLSI guidelines (2019). RESULTS: Totally 75 isolates of Enterococci were isolated. The highest resistance in all isolates was against Ciprofloxacin (88%), Erythromycin (81.30%) and Ampicillin (77.33%). The most effective drugs were Linezolid with only 2.66% resistance and Vancomycin with 10.66% resistance. High-level Gentamicin (HLG) resistance was seen in 58.66% of cases and high-level Streptomycin (HLS) resistance was seen in 53.33% of cases. Totally 35 strains showed a combined resistance for both HLG and HLS, which was 46.66%. A total of seven cases were Vancomycin-resistant Enterococci (VRE), 85.6% of which showed high-level Aminoglycoside resistance (HLAR). Resistance for Linezolid was reported at 28.6%. CONCLUSIONS: Female patients presenting with urinary tract infection are the most common patients with enterococcal infections, with hospitalised patients being more prone, especially in the middle age groups. Appropriate antibiotics need to be instituted after performing antibiotic susceptibility testing to reduce treatment failure arising from HLAR and VRE strains. All VRE isolates should be tested for minimal inhibitory concentration before declaring them Vancomycin resistant.