Status Of High Level Gentamicin Resistant In An Enterococcus Species Isolated From RIMS, Hospital.

Abstract

Background: Infections by enterococci have traditionally been treated by cell wall active agents in combination with an aminoglycoside. However emergence of high level aminoglycoside resistant (HLAR), beta lactam antibiotics and vancomycin resistant by some strains of enterococci led to failure of synergistic affects of combination therapy. The present study was undertaken to find out HLAR in RIMS, Hospital due to the fact that enterococci are causing 2nd leading cause of nosocomial infection and 3rd leading cause of bacteremia. Methods: Enterococci recovered from various specimens of RIMS, Hospital Imphal between November 2013 to May 2015 were identified and speciated by test scheme proposed by Facklam and Collin. Antibiotic susceptibility testing was done by Kirby bauer disc diffusion method as per CLSI Screening for high level gentamicin resistant(HLGR) was done by disc diffusion containing 120 mµ gentamicin and minimum inhibitory concentration of HLG was determined by E-test strip procured from Hi-media. E.faecalis ATCC 29212 were used for quality control strains. Results: Of 5300 clinical samples, 54 isolates were identified as enterococcal strains of which 33 were E.faecalis, 18 were E.faecium and 3 were E.gallinarum. The E.faecalis strains shows resistant high level gentamicin 5/33 (15.15%). The E.faecium strains are resistant to high level gentamicin 12/18 (66.66%) and all the E.gallinarum strains are resistant high level gentamicin Minimum inhibitory concentration for high level gentamicin among the 54 enterococcal isolates were carried out, among them 33 isolates showed MIC of ≤ 4 µg/ml and 21 isolates showed MIC of >1024 µg/ml.