Diagnostic Medical Laboratory Unit, Felege-Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia.
Department of Medical Laboratory Science, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.
PLoS One. 2021 Apr 8;16(4):e0249823. doi: 10.1371/journal.pone.0249823. eCollection 2021.
Vancomycin resistant enterococci (VRE) and vancomycin resistance coagulase negative staphylococci (VRCoNS) are common pathogens causing difficult to treat health care associated infections (HAI). Hence, the World Health Organization listed VRE as one of the high priority pathogens for new antibiotic discovery and antimicrobial resistance surveillance. Despite this, data on the prevalence of VRE and VRCoNS in Ethiopia is scarce. Thus, the present study determined prevalence of VRE and VRCoNS among patients attending Felege-Hiwot comprehensive specialized hospital, Ethiopia.
A hospital based cross-sectional study was conducted on 384 patients selected conveniently from February to March 2020. Data on demographic and clinical variables were collected using a structured questionnaire by face-to-face interview. Simultaneously urine, venous blood and wound swab were collected and processed following standard bacteriological technique. Antimicrobial susceptibility test was performed by minimum inhibitory concentration method using E-test for vancomycin and Kirby-Bauer disc diffusion method for other classes of antibiotics. Data was entered and analyzed using SPSS version 23. Logistic regression was performed to identify factors associated with VRE infection. P. value < 0.05 was considered as statistically significant.
The prevalence of enterococci and CoNS were 6.8% and 12% respectively. The prevalence of VRE was 34.61% (9/26), while all CoNS (46 isolates) were susceptible to vancomycin. The majority (66.7%) of VRE was isolated from blood samples. Furthermore all VRE (100%), 58.8% of vancomycin susceptible enterococci and 45.7% of CoNS were multidrug resistant (MDR). Having educational level of secondary school and below (AOR = 12.80, CI = 1.149-142.5), previous exposure to catheterization (AOR = 56.0, CI = 4.331-724.0) and previous antibiotic use practice (AOR = 26.25, CI = 3.041-226.2) were a significant associated explanatory factor for VRE infection.
The prevalence of vancomycin resistance enterococci, which is also multidrug resistant, was significantly high. Though no vancomycin resistance CoNS detected, the MDR level of CoNS was high. Thus to limit enterococci and CoNS infections and MDR development, focused infection prevention measures should be implemented.
耐万古霉素肠球菌（VRE）和耐万古霉素凝固酶阴性葡萄球菌（VRCoNS）是引起治疗困难的医疗保健相关感染（HAI）的常见病原体。因此，世界卫生组织将 VRE 列为新抗生素发现和抗菌药物耐药性监测的高优先级病原体之一。尽管如此，关于埃塞俄比亚 VRE 和 VRCoNS 流行率的数据仍然很少。因此，本研究旨在确定在埃塞俄比亚 Felege-Hiwot 综合专科医院就诊的患者中 VRE 和 VRCoNS 的流行率。
这是一项 2020 年 2 月至 3 月期间在 384 名患者中进行的基于医院的横断面研究。通过面对面访谈使用结构化问卷收集人口统计学和临床变量数据。同时采集尿液、静脉血和伤口拭子，并按照标准细菌学技术进行处理。使用 E-试验测定万古霉素的最低抑菌浓度法和 Kirby-Bauer 纸片扩散法测定其他类别的抗生素的药敏试验。使用 SPSS 版本 23 输入和分析数据。采用逻辑回归分析鉴定与 VRE 感染相关的因素。P 值<0.05 被认为具有统计学意义。
肠球菌和凝固酶阴性葡萄球菌的流行率分别为 6.8%和 12%。VRE 的流行率为 34.61%（9/26），而所有 CoNS（46 株）均对万古霉素敏感。大多数（66.7%）VRE 分离自血液样本。此外，所有 VRE（100%）、58.8%的万古霉素敏感肠球菌和 45.7%的 CoNS 均为多药耐药（MDR）。具有中学及以下教育水平（AOR=12.80，CI=1.149-142.5）、有导管插入史（AOR=56.0，CI=4.331-724.0）和以前使用过抗生素（AOR=26.25，CI=3.041-226.2）是 VRE 感染的显著相关解释因素。
耐万古霉素肠球菌（VRE）的流行率很高，且也是多药耐药菌。虽然没有检测到耐万古霉素凝固酶阴性葡萄球菌（VRCoNS），但凝固酶阴性葡萄球菌的多药耐药率很高。因此，为了限制肠球菌和凝固酶阴性葡萄球菌感染和多药耐药性的发展，应实施有针对性的感染预防措施。
