A survey of antimicrobial susceptibility of clinical isolates of Enterococcus spp. from Irish hospitals.

Nosocomial enterococcal infections are increasing. In order to establish the species distribution and antibiotic resistance patterns of enterococci in clinical specimens from hospitalized patients, we undertook a survey of 23 Irish hospitals. One thousand and five viable enterococcal strains were studied. Nine different species of enterococci were identified, including Enterococcus faecalis (84%); Enterococcus faecium (9%); and Enterococcus hirae (3%). The most common sites of isolation were the urinary tract (66%), wound and soft tissues (23%) and blood stream (3%). Many of the isolates were multiply antibiotic resistant. Ampicillin resistance was detected in 16%. Neither beta-lactamase production, nor high level penicillin resistance was detected. High level gentamicin resistance was evident in 7% of isolates and varied among species, e.g. 4% E. faecalis, 24% E. faecium, and 34% E. hirae. A number of isolates (23%) were also highly resistant to streptomycin. No clinically significant glycopeptide resistance was detected. The species distribution and incidence of multiple resistance was geographically widespread. This emphasizes the need for detailed speciation and in-vitro susceptibility testing along with the evaluation of alternative combination chemotherapeutic regimens for the management of serious enterococcal infection.