Magnitude of vancomycin-resistant Enterococci colonization and associated factors among people living with HIV

TL;DR

This study found a low rate of vancomycin-resistant Enterococci (VRE) colonization among HIV patients in Ethiopia, but high multidrug resistance, with prior antibiotic use as a key risk factor.

Contribution

The study identifies the prevalence and risk factors of VRE colonization in HIV patients in Eastern Ethiopia.

Findings

26.2% of participants were colonized with Enterococcus spp., with 5 cases of VRE.

88.2% of Enterococcus isolates showed multidrug resistance.

Previous antibiotic treatment was significantly associated with VRE colonization.

Abstract

The limited alternatives for managing vancomycin-resistant Enterococci (VRE) have caused concern in the global community for severe infectious diseases. Therefore, the purpose of the study was to determine the magnitude of VRE colonization and associated factors among people living with HIV at Hiwot Fana Comprehensives Specialized University Hospital, Eastern Ethiopia.

A cross-sectional study was conducted among 260 patients on anti-retroviral therapy (ART) who attended the ART clinic from 10 April to 10 May 2022. A structured questionnaire was used to gather information. The stool sample was collected and processed by standard microbiological techniques. The Bile Esculin Azide Agar and blood agar were used to isolate Enterococci species (spp.). The antimicrobial susceptibility testing of the isolates was performed using the Kirby–Bauer disk diffusion technique on the Mueller–Hinton agar plate. Data were analysed using Statistical Package for the Social Sciences 25 software. The chi-square (χ2) test was used to determine the strength of the association. A P-value of  ≤ 0.05 was considered statistically significant.

Out of the 260 participants, colonization of Enterococcus spp. from stool specimens were observed among 68 (26.2%). Of these, five were VRE. Multidrug resistance was noted in 60 (88.2%) of the Enterococcus spp. isolates. Previous antibiotic treatment was significantly associated with VRE (χ2 = 7.063, P-value = 0.009).

VRE must be regularly monitored for antimicrobial susceptibility testing and surveillance to prevent the spread of antibiotic resistance.

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