In vitro antimicrobial susceptibility in clinical isolates of Enterococcus species.
OBJECTIVE
To describe the antimicrobial activity of several antimicrobial agents against 97 clinical significant isolates of Enterococcus spp.


METHODS
During a 2-year prospective study at Instituto Nacional de Pediatria (National Institute of Pediatrics) in Mexico City. Ninety seven strains of Enterococcus spp. (60 E faecalis and 37 E. faecium) were tested against 11 antibiotics. Susceptibility tests were performed with agar, according to the standards of the sNational Committee for Clinical Laboratory Standards (NCCLS). Isolates were screened for high-level resistance (HLR) to beta-lactams, aminoglycosides, glycopeptides and other antibiotics, as well as for vancomycin-phenotypes. Differences between proportions were evaluated with chi 2 of Fisher exact fest.


RESULTS
Overall resistance rates to the antibiotics tested were: 17/97 (17.5%) to penicillin, ampicillin, amoxicillin-clavulanate and imipenem. There was neither HLR nor beta-lactamase production; 74/97 (48.4%) were resistant to erythromycin; 60% to ciprofloxacin; 31/97 (32%) to gentamicin, and 55/97 (56.7%) to streptomycin. Seven strains were vancomycin-resistant enterococci (VRE), all of them identified as E. faecium; 5/7 with Van A and 2/7 with Van B phenotypes. All the isolates were susceptible to linezolid. The difference in susceptibility among species was significant.


CONCLUSIONS
Mutidrug-resistant enterococci is a real problem and continuous surveillance is necessary. The microbiology laboratory is the first line of defense against the spread of multiantibiotic-resistan enterococci in the hospital environment. All the strains recovered should be tested for susceptibility to ampicillin, streptomycin, gentamicin and glycopeptides. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.
Departamento de Inmunoquímica y Biología Celular, Edificio Mundet Tercer Piso, Hospital Infantil de México Federico Gómez, Calle Dr. Márquez 162, Colonia Doctores, 06720, México, D.F., México. ecalderj@yahoo.com
Ernesto
E
Calderón-Jaimes
José Luis
JL
Arredondo-García
Felipe
F
Aguilar-Ituarte
Pilar
P
García-Roca
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D018432:Drug Resistance, Multiple; D016983:Enterococcus / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D066298:In Vitro Techniques; D008826:Microbial Sensitivity Tests / Q000706:statistics & numerical data*; D011446:Prospective Studies
D000900:Anti-Bacterial Agents