Enterococcal Infections: A Comparative Analysis between the Pandemic and the Pre-pandemic Period

Abstract

Introduction: During the COVID-19 pandemic, higher Enterococcus bloodstream infections (BSI) rates have been reported. To establish whether these infections actually increased, we compared the incidence of Enterococcal infections before (September 2019 to February 2020) and during the pandemic (April 2020 to March 2022). Materials and Methods: This retrospective observational study was conducted at a tertiary care center converted into a COVID-19 facility. All clinical samples received in our laboratory during the study period were included. Results: In the six months preceding the pandemic, 2,243 samples were positive for bacterial growth; of the isolated organisms, 100 were Enterococcus species. During the pandemic, 39 out of 996 positive samples were Enterococcus. E. faecium was the most common isolate, 79/99 and 37/39. BSI was the most common overall infection (554/996; 55.6%) compared to the period before it (287/2243; 12.79%). Enterococcus species accounted for 30 out of 554 (5.41%) BSI in COVID-19 patients and 21/287 in the period before it (7.31%). Ten out of 39 (25.64%) isolates were vancomycin-resistant compared to the pre-COVID-19 period (9/21; 42.8%). There was an increase in antimicrobial resistance in the pandemic, except for linezolid and high-level aminoglycoside. Conclusion: Although we noted a higher percentage of BSIs, Enterococci were isolated from a lesser rate of COVID-19 patients from our center compared to pre-pandemic times. The plausible reasons for this could be the protective gut microbiota in the Indian population, and no increase in Enterococcus species in the environment of patients.