Emergence of multidrug-resistant uropathogenic Enterococcus species in eastern India: A growing clinical challenge

Background: Uropathogenic Enterococcus species have emerged as formidable nosocomial pathogens due to their intrinsic and acquired antimicrobial resistance mechanisms, with vancomycin-resistant enterococci (VRE) representing a critical public health threat. Objective: This study aimed to determine the prevalence, species distribution, and antimicrobial resistance profiles of Enterococcus species isolated from urinary tract infections (UTIs) at a tertiary care hospital in Eastern India.Methods: In this retrospective, cross-sectional study conducted from ۱st October ۲۰۲۳ to ۳۰th September ۲۰۲۴, we analyzed ۲,۲۴۸ urine samples. Enterococcus isolates were identified and speciated using standard microbiological procedures, and antimicrobial susceptibility testing was performed using an automated system (MicroScan WalkAway® plus).Results: Enterococcus spp. accounted for ۱۹% (۱۴۸/۷۸۸) of culture-positive UTIs. Enterococcus faecalis (۶۲%, n=۹۲) was the predominant species, followed by Enterococcus faecium (۳۸%, n=۵۶). A high prevalence of multidrug resistance was observed, which was more pronounced in E. faecium. Alarmingly, vancomycin resistance was identified in ۳۹.۳% (۲۲/۵۶) of E. faecium and ۱۹.۶% (۱۸/۹۲) of E. faecalis isolates. Key risk factors included inpatient status (۹۲%), particularly in intensive care units (۶۴% of inpatients), and catheterization (۴۴%).Conclusion: This study reveals a high burden of multidrug-resistant and vancomycin-resistant Enterococcus spp. causing UTIs in our setting. The findings underscore the critical need for routine speciation, ongoing antimicrobial susceptibility surveillance, and robust antimicrobial stewardship programs to guide effective therapy and curb the spread of these resistant pathogens.

کلیدواژه ها:

Urinary tract infection ، uropathogen ، Enterococci ، Multidrug Resistance ، Vancomycin-Resistant Enterococcus (VRE)