POL Scientific / Bladder / Volume 11 / Issue 2 / DOI: 10.14440/bladder.2024.0016
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BRIEF REPORT

Oral antimicrobial options for vancomycin-resistant Enterococcus isolates in urine culture

Roxanna S. D. Mohammed1 Eugene Y. H. Yeung2,3*
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1 Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
2 Continuing Pharmacy Professional Development, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
3 Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
Bladder 2024 , 11(2), e21200008; https://doi.org/10.14440/bladder.2024.0016
Submitted: 13 July 2024 | Accepted: 2 September 2024 | Published: 10 September 2024
© 2024 by the Bladder published by POL Scientific. Licensee POL Scientific, USA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Objectives: The present study aimed to investigate the susceptibility profiles of vancomycin-resistant Enterococcus isolates in urine culture to create an antibiogram to guide selection of oral antimicrobials in British Columbia (BC), Canada. Methods: An audit was conducted on all urine cultures reported from January 1, 2021, to December 31, 2023, in LifeLabs BC microbiology laboratories. Enterococcus species in urine were routinely tested with ampicillin, ciprofloxacin, nitrofurantoin, tetracycline, and vancomycin. Linezolid and fosfomycin were tested in selected cases. Results: Three hundred and thirty-five vancomycin-resistant Enterococcus faecium, 47 vancomycin-resistant Enterococcus faecalis, 48 Enterococcus gallinarum, 25 Enterococcus casseliflavus, and no Enterococcus flavescens isolates were reported in urine culture. Vancomycin-resistant E. faecium isolates were >90% susceptible to linezolid, but <15% susceptible to ampicillin, ciprofloxacin, nitrofurantoin, and tetracycline. Vancomycin-resistant E. faecalis isolates were >90% susceptible to ampicillin, linezolid, and nitrofurantoin, but <10% susceptible to ciprofloxacin and tetracycline. E. casseliflavus isolates were >90% susceptible to ampicillin, nitrofurantoin, and tetracycline. E. gallinarum isolates were >90% susceptible to ampicillin and nitrofurantoin. In the seven and 263 selected cases of vancomycin-resistant E. faecium and E. faecalis, respectively, fosfomycin susceptibility rates were 57% and 86%, respectively. Conclusions: Ampicillin and nitrofurantoin may be considered for urinary tract infections secondary to vancomycin-resistant E. faecalis, E. casseliflavus, and E. gallinarum. Tetracycline may also be considered for E. casseliflavus. Linezolid remained to be the only reliable oral antimicrobial for vancomycin-resistant E. faecium.

Keywords
Ampicillin
Antimicrobial
Ciprofloxacin
Enterococcus species
Fosfomycin
Linezolid
Nitrofurantoin
Oral therapy
Tetracycline
Vancomycin-resistant Enterococcus
Funding
None.
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Conflict of interest
Eugene Y.H. Yeung is working as a microbiologist, physician, pharmacist, and clinical assistant professor. The views and opinions expressed are those of the authors and do not necessarily reflect the views or positions of their employers.
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Bladder, Electronic ISSN: 2327-2120 Print ISSN: TBA, Published by POL Scientific