Department of Medical Microbiology, Arba Minch University, Arba Minch, Ethiopia.
PLoS One. 2021 Jun 24;16(6):e0251727. doi: 10.1371/journal.pone.0251727. eCollection 2021.
The emergence of vancomycin resistant Enterococci (VRE) has alarmed the global community due to its tendency for colonization of the gastrointestinal tract. Human Immunodeficiency Virus (HIV) patients are colonized by vancomycin resistant Enterococci than other groups. The aim of this study was to determine the incidence of vancomycin resistant Enterococci and its associated factors among HIV infected patients on Anti-Retroviral Therapy (ART).
Institution based cross sectional study was conducted among HIV infected patients on ART at from June 1 to August 30, 2020. Socio-demographic and clinical data were collected by pre-tested structured questionnaire. Stool sample was collected and processed by standard microbiological techniques. Kirby Bauer Disc diffusion method was used to perform antimicrobial susceptibility testing. Data were entered by Epi data version 4.6.0.2 and analyzed by SPSS version 25. Bivariable and multivariable logistic regression model was used to analyze the association between dependent and independent variables. P-values in the multivariable analysis, adjusted odds ratio (AOR) and 95% confidence interval (CI) were used to determine the strength of association. P-value ≤0.05 was considered as significant.
Enterococci spp was isolated on 123/200 (61.50%) patients. Among these isolates, the incidence of vancomycin resistant Enterococci was 11.4% [95% CI: (6.0-17.0)]. Antimicrobial susceptibility patterns against Enterococci showed highest rate of resistance to ampicillin (69.9%). Multidrug resistances were observed in 49.59% of Enterococci isolates. Study participants who had prior antibioticexposurer more than two weeks [AOR = 7.35; 95% CI: (1.2144.64)] and hospitalization for the last six months [AOR = 5.68; 95% CI: (1.09 29.74)] were significantly associated with vancomycin resistant Enterococci.
In our study high incidence of vancomycin resistant Enterococci was found. Previous exposure to antibiotics for more than two weeks and hospitalization for more than six months were significantly associated with vancomycin resistant Enterococci. The isolated Enterococci had variable degrees of resistance to commonly prescribed antibiotics. Therefore, periodic surveillance on antimicrobial resistance pattern, adhering to rational use of antibiotics and implementing infection prevention protocols may reduce colonization by VRE.
由于万古霉素耐药肠球菌（VRE）倾向于定植于胃肠道，因此其出现引起了全球社区的警惕。与其他人群相比，人类免疫缺陷病毒（HIV）患者更容易定植万古霉素耐药肠球菌。本研究旨在确定接受抗逆转录病毒治疗（ART）的 HIV 感染患者中万古霉素耐药肠球菌的发生率及其相关因素。
2020 年 6 月 1 日至 8 月 30 日，我们在接受 ART 的 HIV 感染患者中进行了一项基于机构的横断面研究。通过预先测试的结构化问卷收集社会人口统计学和临床数据。采集粪便样本并采用标准微生物学技术进行处理。采用 Kirby Bauer 纸片扩散法进行抗菌药物敏感性试验。数据由 EpiData 版本 4.6.0.2 录入，由 SPSS 版本 25 进行分析。采用单变量和多变量逻辑回归模型分析因变量与自变量之间的相关性。多变量分析中的 P 值、调整后的比值比（AOR）和 95%置信区间（CI）用于确定关联的强度。P 值≤0.05 被认为具有统计学意义。
200 名患者中有 123 名（61.50%）分离出肠球菌属。在这些分离株中，万古霉素耐药肠球菌的发生率为 11.4%[95%CI：（6.0-17.0）]。肠球菌属对抗菌药物的药敏试验显示，对氨苄西林的耐药率最高（69.9%）。49.59%的肠球菌属分离株表现出多药耐药性。研究参与者中，有超过两周的抗菌药物暴露史[比值比（AOR）=7.35；95%置信区间（CI）：（1.2144.64）]和过去六个月内住院治疗[AOR=5.68；95%CI：（1.09 29.74）]与万古霉素耐药肠球菌显著相关。
在我们的研究中，万古霉素耐药肠球菌的发生率很高。超过两周的抗生素暴露史和超过六个月的住院治疗史与万古霉素耐药肠球菌显著相关。分离出的肠球菌属对常用抗生素有不同程度的耐药性。因此，定期监测抗菌药物耐药模式，坚持合理使用抗生素和实施感染预防方案，可能会减少 VRE 的定植。
