title: Clinico-epidemiological profile and high-level aminoglycoside resistance in enterococcal septicemia from a tertiary care hospital in east Delhi.
abstract: BACKGROUND
  Emergence of high-level aminoglycoside and glycopeptide resistance has significantly contributed to the mortality, particularly in serious enterococcal infections.
  
  
  OBJECTIVE
  This study was aimed to determine the prevalence of high-level gentamicin resistance (HLGR), high-level streptomycin resistance (HLSR) and vancomycin resistance in enterococcal isolates recovered from patients with bacteremia.
  
  
  METHODS
  A total of 110 blood culture isolates of enterococci were recovered from septicemic patients. Routine antibiotic susceptibility testing was performed and screening for ampilcillin, high-level aminoglycoside resistance (HLAR) and high-level vancomycin resistance was done by agar screen method.
  
  
  RESULTS
  Out of 110 isolates, Enterococcus faecium accounted for 53% of these isolates, followed by Enterococcus fecalis (33%), Enterococcus casseliflavus (8%), Enterococcus raffinosus (4%) and Enterococcus dispar (2%). Resistance to ampicillin, HLGR, HLSR and HLAR was detected in 58%, 62%, 58% and 54% of the isolates, respectively. No isolate was resistant to vancomycin.
  
  
  CONCLUSIONS
  This study illustrates the high prevalence of HLAR in enterococci from patients with septicemia in our region, which emphasizes the need to predict synergy between beta-lactams and aminoglycosides for management of enterococcal infections.
authors.affiliation: Department of Microbiology, University College of Medical Sciences & Guru Teg Bahadur Hospital, Delhi, India.
authors.forename: Sarika
authors.initials: S
authors.lastname: Jain
authors.forename: Ashwani
authors.initials: A
authors.lastname: Kumar
authors.forename: Bineeta
authors.initials: B
authors.lastname: Kashyap
authors.forename: Iqbal R
authors.initials: IR
authors.lastname: Kaur
keywords: Antibiotic resistance; enterococcus; vancomycin