Changing Susceptibility of Enterococcus Species in Urinary Isolates in a Tertiary Care Hospital

Abstract

Objective: To determine the efficacy of Fosfomycin against the Enterococcus species and if can still be the drug of choice for lower urinary tract infections.

Setting: This study was conducted from August 2022 to March 2024 at Microbiology Laboratory, MTI- GKMC/BKMC, Swabi, KPK.

Methodology: After seeking permission from the institutional review board, a total of 3000 urine samples were received at Microbiology Department of Bacha Khan Medical Complex, Swabi, KPK in the said time period for culture and sensitivity. Urine specimens were inoculated on Cysteine Lactose Electrolyte Deficient (CLED) agar (Oxoid, UK) and incubated aerobically at 35°C ± 2 for 18 to 24 hours. After identification of colony morphology, Gram staining and biochemical reactions were carried out to confirm if it was Enterococcus species, antimicrobial susceptibility testing was carried out. Demographic data of the patients was also recorded.

Results: Out of the total 3000 urine samples received at Microbiology Department of BKMC, Swabi, 95 samples yielded the growth of Enterococcus species out of which 22% were Vancomycin resistant and showed 51% resistance to Fosfomycin.

Conclusion: An increased rate of fosfomycin resistance against Enterococcal isolates was observed in our study, which urges cautious prescription of Fosfomycin and it is necessary to continuously monitor fosfomycin resistance in future as well.