title: Emergence of multidrug resistant enterococci at a tertiary care centre.
abstract: BACKGROUND
  Enterococci have assumed great clinical importance because of their increasing resistance to various antimicrobial agents. Thus, knowledge about the antibiogram of these multidrug resistant isolates is of utmost importance in formulating an effective antibiotic policy to treat these infections and reducing the morbidity and mortality. Aim of this study was to assess the antimicrobial resistance pattern of enterococci and determine the prevalence of multidrug resistance among them.
  
  
  METHODS
  This cross sectional study was carried out from August 2011 to February 2014, in which 200 non-repetitive clinical isolates of enterococci were included. Antimicrobial susceptibility testing was done by disc diffusion method. Minimum inhibitory concentration (MIC) of gentamicin, streptomycin, vancomycin, teicoplanin and linezolid was determined by E-test method.
  
  
  RESULTS
  The prevalence of multidrug resistance among enterococcal isolates was found to be 63%. Varying levels of resistance was seen to various antibiotics. Most of the isolates were resistant to penicillin (95%), ampicillin (95%) and cotrimoxazole (90%). High level aminoglycoside resistance (HLAR) and glycopeptide resistance was seen in 39% and 14% isolates respectively. Only 4 isolates (2%) were found to be resistant to linezolid.
  
  
  CONCLUSIONS
  The prevalence of multidrug resistance among enterococci was found to be 63%, the resistance being more common in Enterococcus faecium as compared to Enterococcus faecalis. The study highlights the emergence and increased prevalence of multidrug resistant enterococci which pose a serious therapeutic challenge.
authors: Graded Specialist (Microbiology), Command Hospital (Southern Command), Pune 411040, India.
authors: Puneet
authors: P
authors: Bhatt
authors: Resident, Dept of Microbiology, Armed Forces Medical College, Pune 411040, India.
authors: Anubha
authors: A
authors: Patel
authors: Professor & Head, Dept of Microbiology, Armed Forces Medical College, Pune 411040, India.
authors: A K
authors: AK
authors: Sahni
authors: Professor & Head, Dept of Microbiology, AIIMS, Bhubhaneshwar, India.
authors: A K
authors: AK
authors: Praharaj
authors: Professor, Dept of Microbiology, Armed Forces Medical College, Pune 411040, India.
authors: Naveen
authors: N
authors: Grover
authors: Professor (Microbiology), INHS, Asvini, Mumbai, India.
authors: C N
authors: CN
authors: Chaudhari
authors: Resident, Dept of Microbiology, Armed Forces Medical College, Pune 411040, India.
authors: Nikunja Kumar
authors: NK
authors: Das
authors: Resident, Dept of Microbiology, Armed Forces Medical College, Pune 411040, India.
authors: Mayuri
authors: M
authors: Kulkarni
keywords: Antimicrobial susceptibility testing; Glycopeptide resistance; High-level aminoglycoside resistance; Minimum inhibitory concentration; Multidrug resistant enterococci