Yilema Amelework, Moges Feleke, Tadele Sisay, Endris Mengistu, Kassu Afework, Abebe Wondwossen, Ayalew Getnet
Ethiopia public health institute, P.O.Box-1242, Addis Ababa, Ethiopia.
BMC Infect Dis. 2017 Apr 17;17(1):276. doi: 10.1186/s12879-017-2363-3.
Enterococci become clinically important especially in immune compromised patients and important causes of nosocomial infections. Data on the prevalence, antimicrobial susceptibility patterns and associated factors of enterococci are scarce in Ethiopia.
A hospital based cross-sectional study was conducted at the University of Gondar Teaching Hospital from February 28, 2014 to May 1, 2014. Pretested structured questionnaire was used to collect socio-demographic data and possible associated factors of enterococci infections. Clinical samples including urine, blood, wound swabs and other body fluids from patients requested by physician for culture and antimicrobial susceptibility test during the study period were included. A total of 385 patients were included in the study. Data were entered and analyzed using SPSS Version 20. P values <0.05 were considered as statistically significant.
The overall prevalence of enterococci infection was 6.2% (24/385). The commonest sites of infections were urinary tract followed by wound and blood. Among the 24 isolates, 33.3% (8/24) were resistant to all tested antimicrobial agents. Forty one point 7 % (10/24) of the enterococci isolates were vancomycin resistant enterococci (VRE). Moreover, two third of the isolates were multidrug resistant (MDR) enterococci. In multivariate analysis, duration of hospital stay for two days and more than two days with infection rate 17/32 (53.1%), previous history of any antibiotics (AOR = 9.13; [95% CI; 2.01-41.51] P = 0.00) and history of urinary catheterization (AOR = 8.80; [95% CI; 1.70-45.64] P = 0.01) were associated with presence of higher enterococci infections than their respective groups.
The prevalence of enterococci infections among patients with UTIs, wound infections and sepsis were higher than the other infections. Multi drug resistant enterococci including VRE were isolated from clinical samples in the study area. Being hospitalized for ≥48 h, having history of any antibiotic administration and catheterization were associated factors for enterococci infections. Presence of VRE indicates decreased antibiotic treatment options of multidrug resistant enterococci. Therefore, efforts should be made to prevent enterococci infections and emergency of multidrug resistant enterococci. Moreover, species identification and antibiotic resistant in advanced and at large scale is demanding.
肠球菌在临床上变得尤为重要，特别是在免疫功能低下的患者中，并且是医院感染的重要原因。在埃塞俄比亚，关于肠球菌的患病率、抗菌药物敏感性模式及相关因素的数据很少。
2014年2月28日至2014年5月1日，在贡德尔大学教学医院进行了一项基于医院的横断面研究。使用预先测试的结构化问卷收集社会人口统计学数据和肠球菌感染的可能相关因素。纳入研究期间医生要求进行培养和抗菌药物敏感性测试的患者的临床样本，包括尿液、血液、伤口拭子和其他体液。共有385名患者纳入研究。使用SPSS 20版输入和分析数据。P值<0.05被认为具有统计学意义。
肠球菌感染的总体患病率为6.2%（24/385）。最常见的感染部位是泌尿道，其次是伤口和血液。在24株分离株中，33.3%（8/24）对所有测试抗菌药物耐药。41.7%（10/24）的肠球菌分离株是耐万古霉素肠球菌（VRE）。此外，三分之二的分离株是多重耐药（MDR）肠球菌。在多变量分析中，住院时间为两天及以上且感染率为17/32（53.1%）、有任何抗生素使用史（调整后比值比[AOR]=9.13；[95%置信区间（CI）；2.01-41.51]，P=0.00）以及有导尿史（AOR=8.80；[95%CI；1.70-45.64]，P=0.01）与肠球菌感染率高于各自组相关。
尿路感染、伤口感染和败血症患者中肠球菌感染的患病率高于其他感染。在研究区域的临床样本中分离出了包括VRE在内的多重耐药肠球菌。住院≥48小时、有任何抗生素使用史和导尿史是肠球菌感染的相关因素。VRE的存在表明多重耐药肠球菌的抗生素治疗选择减少。因此，应努力预防肠球菌感染和多重耐药肠球菌的出现。此外，迫切需要在更大规模上进行菌种鉴定和抗生素耐药性研究。
