An Overview of Enterococcal Bacteremia with Potential Therapeutic Options.

Abstract

Background and aims: Enterococci, particularly vancomycin-resistant Enterococci (VRE), pose a significant clinical challenge due to rising pathogenicity and antimicrobial resistance. This study aims to examine the prevalence of Enterococcal bacteremia and their antibiotic susceptibility pattern in a Tertiary Care Hospital in Western India. The study also highlights clinical implications of resistance patterns, emphasizing therapeutic challenges and the need for targeted antimicrobial stewardship to guide effective treatment of Enterococcal infections.

Patients and methods: This is a retrospective observational study conducted in a Tertiary Care Teaching University Hospital. All blood cultures received in the laboratory from October 2022 to September 2023 were included in the study. They were processed using the automated BD BACTEC system and species identification and antibiotic susceptibility testing (AST) were performed using the VITEK 2 Compact system, following Clinical and Laboratory Standards Institute (CLSI) guidelines.

Results: From 10,449 blood cultures received during the study period, 13.18% showed bacterial growth. Of these, 30.33% were gram-positive, with Enterococcus spp. constituting 30.14%. Enterococcus faecium was most prevalent (85.71%), and VRE prevalence was 8.73%. All VRE isolates were resistant to benzylpenicillin and fluoroquinolones, with 80% additionally resistant to linezolid. VanA phenotype was present in all isolates. A total of 100% susceptibility was observed for daptomycin and tigecycline.

Conclusion: Findings of this study underscore the urgent need for stringent infection control measures and prudent antibiotic stewardship to effectively manage and prevent VRE infections.

How to cite this article: Rajni E, Jorwal A, Goyal K, Grag VK. An Overview of Enterococcal Bacteremia with Potential Therapeutic Options. Indian J Crit Care Med 2025;29(7):612-614.