Srinath  Ramamurthy, Radhika  Nalliah, Mohamed  Azarudeen, 
    Surveillance of Antimicrobial Resistance and Multidrug‐Resistant Pathogens in a Tertiary Care Hospital, Chengalpet District, Tamil Nadu,
    Research Journal of Medical Sciences,
    Volume 15,Issue 6,
    2021,
    Pages 156-165,
    ISSN 1815-9346,
    makrjms.2021.156.165,
    (https://makhillpublications.co/view-article.php?doi=makrjms.2021.156.165)
    Abstract: Antimicrobial resistance (AMR) is a growing global health crisis, with
Enterococcus species emerging as significant multidrug‐resistant
pathogens in community and hospital settings. However, regional
surveillance data from southern India remains scarce. To assess the
prevalence of antibiotic resistance and analyse resistance patterns of
Enterococcus and other bacterial isolates from clinical specimens in a
tertiary care hospital in Chengalpet District, Tamil Nadu. We conducted
this observational study at a Tertiary Care Hospital X, attached to the
Medical College XX, in Chengalpet District, Tamil Nadu, from January 2021
onward. 110 clinical samples were processed using standard
microbiological methods, including urine, pus, sputum, blood, and other
fluids. Isolates were identified, and antibiotic susceptibility testing was
performed using the Kirby‐Bauer disk diffusion method according to CLSI
guidelines. Resistance trends were analysed per organism and specimen
type. Multidrug resistance (MDR) was defined as resistance to =3
antibiotic classes. Statistical analysis included Chi‐square and Fisher's
exact tests (p < 0.05 significant). Enterococcus was the most frequently
isolated organism (69.1%), followed by Streptococcus spp. (12.7%) and
MRSA (1.8%). High resistance was observed to Ampicillin (85.1%) and
Ciprofloxacin (60%) in Enterococcus, while Vancomycin (87.5%) and
Linezolid (100%) retained efficacy. Resistance varied significantly across
specimen types (p < 0.05), with urine and blood isolates showing the
highest resistance rates. MDR was identified in 35.5% of Enterococcus,
35.7% of Streptococcus spp., and 50% of MRSA isolates. However, the
overall difference in MDR prevalence between organisms was not
statistically significant (p = 0.915). This study highlights a high burden of
Enterococcus‐associated infections with substantial multidrug resistance,
particularly in urinary and bloodstream isolates. Resistance patterns
varied significantly by specimen type, underscoring the importance of
localised antibiograms and site‐specific empirical therapy. Continued
microbiological surveillance and robust antibiotic stewardship are
imperative in this setting.
    Keywords: Enterococcus; antimicrobial resistance; multidrug resistance; vancomycin; tertiary care; Nagaland; site‐specific resistance; antibiogram