Antimicrobial Susceptibility Pattern of Enterococcus Species Isolated From Various Clinical Specimens in a Tertiary Care Center in Western Nepal

  • Anjila Pal Lumbini Medical College and Teaching Hospital
  • Bhim Singh Mahawal Lumbini Medical College and Teaching Hospital
Keywords: Enterococcus, High Level Gentamicin Resistance, Linezolid, Vancomycin Resistant Enterococci


Introduction: Enterococcus species are Gram-positive oval cocci arranged in pairs or short chains. They are found as gut microbiota of adults, but from the last decade, they are emerging as causative agents of various nosocomial infections throughout the world. High level aminoglycoside resistance and vancomycin resistance are being increasingly reported from different parts of the world thus limiting the therapeutic options for the treatment of enterococcal infections. The objective of our study was to determine the antimicrobial susceptibility pattern of Enterococcus species isolated from various clinical specimens in Lumbini Medical College and Teaching Hospital, Palpa. Methods: All the clinical samples were cultured and enterococci isolates were tested for antibiotic sensitivity, high level gentamicin resistance and vancomycin resistance by Kirby Bauer disc diffusion method.Results: Among the 90 isolated Enterococcus spp.maximum isolates were obtained from the age group 21-40 years, most from in-patient department with urine as sample (n=53, 58.89%). The highest antimicrobial susceptibility was recorded for linezolid (90.48%) followed by chloramphenicol (79.71%), nitrofurantoin (76.83%) and then high-level gentamicin (70%). The overall prevalence of high level gentamicin resistance and vancomycin resistant enterococci were 30% and 35.55% respectively. Conclusion: The present findings show a high rate of high-level gentamicin and vancomycin resistant enterococci. Thus, routine surveillance of such resistance pattern should be done every year. Linezolid can be considered as a drug of choice to treat serious enterococcal infections.


Download data is not yet available.

Author Biographies

Anjila Pal, Lumbini Medical College and Teaching Hospital


Department of Microbiology. 

Bhim Singh Mahawal, Lumbini Medical College and Teaching Hospital

Professor and Head,

Department of Microbiology.


Nalayini S. A Study of Prevalence of Vancomycin Resistance among the Enterococcus spp. Isolated from Various Clinical Samples in a Tertiary Care Hospital in Chennai [dissertation]. [Chennai, India]: The Tamilnadu Dr. M.G.R. Medical University;2013. 122p. Available from: http:/

Ghidán A. Epidemiology of vanA gene carrier entero- cocci : Molecular characterisation, antibiotic sensitivity and phylogenetic relationship of Hungarian isolates. [Ph.D. Thesis]. [Budapest]: Semmelweis University. 2007. 97p. Available from:

Mukherjee K, Bhattacharjee D, Chakraborti G, Chatterjee SS. Prevalence and Antibiotic Susceptibility Pattern of Enterococcus Species from Various Clinical Samples in a Tertiary Care Hospital in Kolkata. International Journal of Contemporary Medical Research. 2016;3(6):1565-7. Available from:

Hällgren A, Abednazari H, Ekdahl C, Hanberger H, Nilsson M, Samuelsson A, et al.Antimicrobial susceptibility patterns of enterococci in intensive care units in Sweden evaluated by different MIC breakpoint systems. J Antimicrob. Chemother. 2001;48(1): 53-62. PMID: 11418512DOI:

Adhikari RP, Shrestha S, Barakoti A, Rai JR, Amatya R. Antimicrobial Susceptibility Pattern of Enterococcus Species Isolated from Various Clinical Specimens in a Tertiary Care Hospital, Kathmandu, Nepal. Nepal Medical College Journal.2018;20(4):173-7. DOI:

Ghimire S, Basnet HB, Joshi LR, Sapkota M. Prevalence of Vancomycin Resistant Enterococci Species in Minced Buffalo Meat of Chitwan, Nepal. International Journal of Applied Sciences and Biotechnology. 2014;2(4):409-12. DOI:

Wagner T. How to Be a Bad Bug: Virulence Determinants of Enterococcus faecium [Internet]. [Accessed on 14th October 2020]. Available from:

Zhong Z, Zhang W, Song Y, Liu W, Xu H, Xi X, et al. Comparative genomic analysis of the genus Enterococcus.Microbiol Res. 2017;196(0):95-105.PMID: 28164795 DOI:

Karna A, Baral R, Khanal B. Characterization of clinical isolates of enterococci with special reference to glycopeptide susceptibility at a tertiary care center of eastern Nepal. International Journal of Microbiology. 2019;2019(0):7936156. DOI:

Getso MI, Sundaramoorthy S, Kanishka HD, Aliyu M, Yusuf I, Azeez-Akande O, et al. Distribution and antibiotics susceptibility patterns of Enterococcus spp. from a selected hospital in India. Journal of Sciences. 2020;4(3):1-9. DOI:

Bhardwaj S, Bhamre K, Dhawale J, Patil M, Divase S. Enterococcus faecium and Enterococcus faecalis, the nosocomial pathogens with special reference to multi-drug resistance and phenotypic characterization. International Journal of Pharmaceutical Sciences and Practice. 2013;2(1):1-10. Available from:

Pandey R, Mishra SK, Shrestha A. Characterisation of ESKAPE Pathogens with Special Reference to Multidrug Resistance and Biofilm Production in a Nepalese Hospital. Research Square. 2019;14(0):1-26. DOI:

Acharya KP, Wilson RT. Antimicrobial Resistance in Nepal. Frontiers in Medicine. 2019;6(0):7-9. DOI:

Dahal RH, Chaudhary DK. Microbial Infections and Antimicrobial Resistance in Nepal: Current Trends and Recommendations. The Open Microbiology Journal. 2018;12(0):230-42. DOI:

Jabbari SM, Shiadeh, Pormohammad A, Hashemi A, Lak P. Global prevalence of antibiotic resistance in blood-isolated enterococcus faecalis and enterococcus faecium: A systematic review and meta-analysis. Infection and Drug Resistance. 2019;2019(0):2713-25. DOI:

Nepal HP, Khanal B, Acharya A. Characterization and antimicrobial resistance of clinical isolates of enterococcci in tertiary care hospital in eastern Nepal. 2013;11(1):17-22. DOI:

HIMEDIA. Antimicrobial Susceptibility Systems [Internet].[Accessed on 7th July 2021]. Available from:

Mittal S, Singla P, Deep A, Bala K, Sikka R, Garg M, et al. Vancomycin and High Level Aminoglycoside Resistance in Enterococcus spp. in a Tertiary Health Care Centre: A Therapeutic Concern. Journal of Pathogens. 2016;2016(0):8262561. DOI:

Srivastava P, Mehta R, Nirwan PS, Sharma M, Dahiya SS. Prevalence and Antimicrobial Susceptibility of Enterococcus Species Isolated from Different Clinical Samples in a Tertiary Care Hospital of North India. National Journal of Medical Research. 2013;3(4):389-91.Available from:

Sreeja S, Babu PRS, Prathab AG. The prevalence and the characterization of the Enterococcus species from various clinical samples in a tertiary care hospital.J Clin Diagn Res. 2012;6(9):1486-8. PMID: 23285436 DOI:

Yilema A, Moges F, Tadele S, Endris M, Kassu A, Abebe W, et al. Isolation of enterococci, their antimicrobial susceptibility patterns and associated factors among patients attending at the University of Gondar Teaching Hospital. BMC Infect Dis.2017;17(1):276. PMID: 28412932 DOI:

Shrestha LB, Baral R, Poudel P, Khanal B. Clinical, etiological and antimicrobial susceptibility profile of pediatric urinary tract infections in a tertiary care hospital of Nepal. BMC Pediatr. 2019;19(1):36.PMID: 30696410 DOI:

Cirak MY, Sultan N. Prevalence of High Level Aminoglycoside and Vancomycin Resistance among Enterococci in Turkey. Acta Microbiol Pol. 1998;47(3):267-73. PMID: 9990710

How to Cite
Pal A, Mahawal B S. Antimicrobial Susceptibility Pattern of Enterococcus Species Isolated From Various Clinical Specimens in a Tertiary Care Center in Western Nepal. J Lumbini Med Coll [Internet]. 3Jan.2022 [cited 22May2022];9(2):6 pages. Available from:
Original Research Article