Antimicrobial Resistance among Faecal Enterococci from the Healthy Individuals in Pokhara, Nepal

Abstract

Background: Enterococci, normal flora in the gastrointestinal tract of humans and animals. Over the last decade, multi-drug resistant (MDR) Enterococci were subject of matter of interest as it is one of the most common causes of nosocomial as well as community-acquired infection around the world. Thus, this study aimed to determine antimicrobial resistance among Fecal Enterococci from healthy individuals in Pokhara, Nepal.

Methods: A total of 100 fecal samples were collected from a community of different parts of Pokhara and processed. Enterococcus isolates were identified phenotypically based on colony morphology, gram staining reaction, biochemical tests and growth on 40% bile-esculin agar. Antimicrobial susceptibility test (AST) was performed as CLSI guidelines and screening for VRE was carried out by vancomycin disc diffusion method.

Results: The distribution of Enterococci was found to be highest in the age group 50-60 years 8 (61.53%) followed by the adult age group 20-30 years 3 (20%) and lowest in the 40-50 age groups (5.13%). Antibiotic susceptibility test revealed that most of the isolates were sensitive to chloramphenicol (53.84%) and resistant to linezolid and erythromycin (79.48%). Out of 39 Enterococci isolates, 71.79% isolates were found to be multi-drug resistance. Among 17 isolates of Enterococci, 7 (17.9%) isolates were vancomycin resistant.

Conclusions: Significant prevalence of Vancomycin resistant Enterococcus in healthy individuals indicates the risk of transmitting VRE to the environmental non-pathogenic bacteria through fecal routes which might pose serious public health threats leading to an epidemic and endemic shortly. With regard to the importance of VRE strains in the clinical and environmental settings, it seems necessary to address the issue. Therefore, regularly surveillance and effective control program must be implemented in order to prevent its dissemination. Otherwise serious community acquired infections will appear in near future.