Gram positive bugs - bugging us in todays era. A study from a tertiary care hospital in Punjab (North India)

Background: Recently there has been a rapid increase in the incidence of infection and colonization of patients with gram positive organisms such as Enterococcus and Staphylococcus which display resistance to many commonly used antimicrobial agents. Materials and methods: A prospective study was conducted over a period of four months in the department of Microbiology of a North Indian hospital. Various clinical samples were collected from the patients, the isolates were identified using standard microbiological methods and subjected to in vitro antimicrobial susceptibility testing by disc diffusion method and newer antimicrobials such as Vancomycin, Teicoplanin and Daptomycin by E test also. Results: A total of 220 isolates of, Enterococci (132) and MRSA (88) were tested. Resistance among Enterococci to various drugs was; Penicillin (88.63%), Erythromycin (76.06%), high level Gentamycin (51.03 %) and Ciprofloxacin (46.21 %). By disc diffusion method Vancomycin and Teicoplanin showed 15.15 % and 7.58 % resistance. Whereas, E test demonstrated lower resistance to Vancomycin (11.36 %) and Teicoplanin (9.09 %). Resistance among MRSA to Erythromycin, Ciprofloxacin, Clindamycin, Vancomycin and Teicoplanin was 64.77, 48.87, 62.50, 4.54 and 2.27 per cent, respectively. Zero percent resistance was seen towards Linezolid. By E test resistance to Daptomycin was 2.27%, whereas all the isolates were sensitive to Vancomycin and Teicoplanin. Conclusions: The spread of antibiotic resistance among organisms, to the point where some isolates are resistant to all standard therapies highlights the looming prospect of a post antibiotic era. Antibiotic policies need to be updated regularly, along with comprehensive monitoring of antibiotic prescription and consumption. Keywords: Gram Positive Organisms, E Test, Vancomycin, Teicoplanin and Daptomycin.