Vancomycin resistant enterococci in urine cultures: Antibiotic susceptibility trends over a decade at a tertiary hospital in the United Kingdom

Liam Toner, Nathan Papa, Sani H. Aliyu, Harveer Dev, Nathan Lawrentschuk, Samih Al-Hayek

Research output: Contribution to journalArticleResearchpeer-review

19 Citations (Scopus)

Abstract

Purpose: Enterococci are a common cause of urinary tract infection and vancomycin-resistant strains are more difficult to treat. The purpose of this surveillance program was to assess the prevalence of and determine the risk factors for vancomycin resistance in adults among urinary isolates of Enterococcus sp. and to detail the antibiotic susceptibility profile, which can be used to guide empirical treatment. Materials and Methods: From 2005 to 2014 we retrospectively reviewed 5,528 positive Enterococcus sp. urine cultures recorded in a computerized laboratory results database at a tertiary teaching hospital in Cambridge, United Kingdom. Results: Of these cultures, 542 (9.8%) were vancomycin resistant. No longitudinal trend was observed in the proportion of vancomycin-resistant strains over the course of the study. We observed emerging resistance to nitrofurantoin with rates climbing from near zero to 40%. Ampicillin resistance fluctuated between 50% and 90%. Low resistance was observed for linezolid and quinupristin/dalfopristin. Female sex and inpatient status were identified as risk factors for vancomycin resistance. Conclusions: The incidence of vancomycin resistance among urinary isolates was stable over the last decade. Although resistance to nitrofurantoin has increased, it still serves as an appropriate first choice in uncomplicated urinary tract infection caused by vancomycin-resistant Enterococcus sp.

Original languageEnglish
Pages (from-to)129-134
Number of pages6
JournalInvestigative and Clinical Urology
Volume57
Issue number2
DOIs
Publication statusPublished - Mar 2016
Externally publishedYes

Keywords

  • Antibiotic prophylaxis
  • Enterococcus
  • Microbial drug resistance
  • Urinary tract infection
  • Vancomycin-resistant enterococci

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