Analysis of the bacterial strains isolated from urine samples of hospitalized and ambulatory patients
Iwona Kania, Eugenia Gospodarek, Beata Ulatowska
Med Sci Monit 2000; 6(6): CR1122-1127
Bacteria of Enterococcus spp. are now much more often isolated from various diagnostic materials in systemic infection, both in hospitalized and in ambulatory patients. The study included 571 enterococci strains isolated from urine in 1997. Species identification was performed by rapid ID32 STREP test (bioMrieux) for 327 analyzed strains. Enterococcus faecalis and Enterococcus faecium dominated (46.1% and 11.2%, respectively). Over 42% of strains were isolated from urine of patients with non-significant bacteriuria or as concomitant flora. In such cases, simplified identification was performed and the strains were determined as Enterococcus spp. The microorganisms analyzed originated primarily from the urine samples of patients hospitalized at the Department of Urology (41.8%), the Department of Neurology (11.9%) and the Department of Internal Medicine and Nephrology (9.9%). Enterococcus faecalis strains were second with respect to population count (263 - 10.6%), after Escherichia coli strains (464 - 18.8%), while Enterococcus faecium strains were the sixth (64 - 2.5%). Enterococcus genus took the first place among all microorganisms isolated from the urine samples. Antibiotic-sensitivity was determined for 323 enterococci strains originating from hospitalized and ambulatory patients. Enterococcus faecium strains, naturally resistant to beta-lactam antibiotics, were sensitive to nitrofuranoin in more than 50% and to norfloxacin in about 20%. Among 254 analyzed Enterococcus faecalis strains, 80.0% were sensitive to ampicillin, nitrofurantoin and high concentrations of gentamicin as well as streptomycin. Enterococci strains isolated from hospitalized patients proved sensitive to ampicillin and carbapenems in 76.8%, while strains isolated from ambulatory patients were 100% sensitive to these drugs. Examination of enterococci isolated from urine of patients hospitalized showed 33.8% sensitive to norfloxacin and 84.6% sensitive to nitrofurantoin. All the enterococci strains were sensitive to glycopeptide antibiotics: vancomycin, teicoplanin.
Keywords: antibiotic-resistance, urine tract infection, Enterococcus