Antimicrobial resistance in enterococcus faecalis and enterococcus faecium bacteria isolated from bloodstream infections: A single-center evaluation

Abstract

Objective: Enterococci are an important cause of healthcare-related bloodstream infections. The present study aimed to contribute to form empirical treatment models that can be used in the treatment of Enterococcus faecalis and En-terococcus faecium bacteria isolated from bloodstream infections in our hospital by reviewing their resistance status against antibiotics, requently used in the treatment of these bacteria. Methods: In our study, the resistance status of E. faecalis and E. faecium bacteria isolated from bloodstream infections in Sivas Cumhuriyet University, Health Services Practice and Research Hospital between January 2015 and June 2020 against ampicillin, amoxicillin, clavulanic acid, high-level gentamicin, linezolid, teicoplanin, and vancomycin was examined retrospectively. The diagnosis of healthcare-related bloodstream infections was made using the diagnostic criteria of “Centers for Diseases Control and Prevention (CDC).” Results: A total of 227 enterococcal isolates were evaluated within the scope of our study between the specified dates. The percentage of patients with Enterococcus bacteria isolated in their blood cultures were 44.5% male, and 55.5% female. Of the isolates, 60.8% were identified as E. faecalis and 39.2% as E. faecium. High-level gentamicin resistance was found to be 25.3% in E. faecalis isolates, and no resistance was found against vancomycin, teicoplanin, and linezol-id. In E. faecium isolates, while the highest resistance was observed against amoxicillin-clavulanic acid and ampicillin with 87.6%, vancomycin resistance was determined to be 3.3%. No resistance to linezolid was identified. Conclusions: Enterococci cause life-threatening infections and there are some difficulties in the treatment. Especially since E. faecium has higher resistance against antibiotics, the agents to be chosen in the treatment of infections caused by these bacteria are limited. Therefore, the current local resistance data will be useful in developing rapid and appropriate treatment models, especially in cases when empirical treatment is required. We think that our study will contribute to the literature in this regard.