DOI: N/A
Alam N, Nigar I, Ahmed I, Sultana A4, Foyzunnahar M, Sarmin R6, Ahmed S
Background: Urinary tract infection (UTI) are among the most common infections caused by Enterococcus species, particularly Enterococcus faecalis and Enterococcus faecium. The clinical importance of enterococci is largely attributed to their intrinsic and acquired resistance to multiple antimicrobial agents. Efflux pump systems such as emeA and efrAB contribute significantly to multidrug resistant (MDR).
Methods: This cross-sectional laboratory-based study included 53 Enterococcus isolates obtained from urine samples of patients with clinically suspected UTI. Antimicrobial susceptibility testing was performed according to CLSI guidelines. MDR was defined as resistance to at least one agent in three or more antimicrobial classes. Detection of efflux pump genes (emeA, efrA, and efrB) was carried out using polymerase chain reaction (PCR).
Results: E. faecalis (81.1%) was the predominant species, followed by E. faecium (9.4%) among the isolates. High resistance rates were observed against tetracycline (94.3%), ciprofloxacin (66%), levofloxacin (62.3%), high-level gentamicin (54.7%), and benzyl penicillin (50.9%). Overall, 64.2% of isolates were identified as MDR. MDR was more frequent in E. faecium (80%) than E. faecalis (55.8%). The emeA gene was detected in 62.8% of E. faecalis and 100% of E. faecium isolates. All MDR isolates carried at least one efflux pump gene.
Conclusion: High prevalence of MDR Enterococcus species, particularly E. faecium, underscores the importance of efflux pumps in antimicrobial resistance. Rational antibiotic use and antimicrobial stewardship programs are essential to limit efflux-mediated resistance.