Vancomycin resistant Enterococci and its associated factors among HIV infected patients on anti-retroviral therapy in Ethiopia.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Anti-Retroviral Agents/*therapeutic use ; Gastrointestinal Tract/*microbiology ; Gram-Positive Bacterial Infections/*epidemiology ; HIV/*isolation & purification ; HIV Infections/*complications ; Vancomycin/*pharmacology ; Vancomycin-Resistant Enterococci/*isolation & purification; Adolescent ; Adult ; Aged ; Anti-Bacterial Agents/pharmacology ; Cross-Sectional Studies ; Ethiopia/epidemiology ; Female ; Gram-Positive Bacterial Infections/microbiology ; HIV Infections/drug therapy ; HIV Infections/microbiology ; HIV Infections/virology ; Hospitalization/statistics & numerical data ; Humans ; Male ; Middle Aged ; Young Adult

Background: 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).
Methods: 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.
Results: 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.
Conclusions: 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.
Competing Interests: The authors have declared that no competing interests exist.

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0 (Anti-Bacterial Agents)
0 (Anti-Retroviral Agents)
6Q205EH1VU (Vancomycin)

Date Created: 20210624 Date Completed: 20211102 Latest Revision: 20231102

20250114

PMC8224944

10.1371/journal.pone.0251727

34166383