ENTEROCOCCAL URINARY TARACT INFECTION: AN EMERGING THREAT

Abstract

INTRODUCTION: Enterococcus faecalis is a frequent cause of hospital acquired urinary tract infection and is being increasingly recognized as a cause of community acquired urinary tract infection. The organism is resistant to commonly used antibiotics, thereby limiting treatment options. OBJECTIVES: To study the epidemiology and resistogram of enterococcal urinary tract infections. MATERIALS AND METHODS: In this study of two years duration (August 2008 to July 2010), we included symptomatic cases of urinary tract infection which showed significant bacteriuria due to Enterococcus faecalis as the sole pathogen. The data concerning the age, gender, type of urinary tract infection were collected from the patients' records. Urine analysis was done following standard microbiological methods, and the antibiogram was done following standard disc-diffusion method on the Mueller-Hinton agar. RESULTS: Community acquired E. faecalis urinary tract infection (50.4%) was as common as nosocomial E. faecalis urinary tract infection (49.6%). Nosocomial urinary tract infections occurred most frequently in the gynecology wards. Of all E. faecalis urinary tract infections more than half occurred in the 21-50 year age group (52.3%) while another 13.04% of cases occurred in 1-5 year age group. There was resistance to ciprofloxacin (86.1%), amikacin (77.4%), co-trimoxazole (78.3%) and imipenem (52.2%) among the enterococcal isolates. Vancomycin resistant enterococci (3.5%) were also isolated. CONCLUSION: Enterococcal urinary tract infection can present as both community acquired and hospital acquired infections. The incidence of drug resistance in E. faecalis is high.