Isolation of enterococci, their antimicrobial susceptibility patterns and associated factors among patients attending at the University of Gondar Teaching Hospital
Isolation of enterococci, their antimicrobial susceptibility patterns and associated factors among patients attending at the University of Gondar Teaching Hospital
复制标题
贡德尔大学教学医院就诊患者中肠球菌的分离、抗菌药物敏感性模式和相关因素
作者：
Amelework Yilema;F. Moges;Sisay Tadele;Mengistu Endris;A. Kassu;W. Abebe;G. Ayalew
背景肠球菌在临床上特别是在免疫功能低下的患者中具有重要意义，是引起医院感染的重要原因。肠球菌的患病率，抗菌药物的敏感性模式和相关因素的数据是稀缺的在Ethiopia.MethodsA医院为基础的横断面研究进行了大学贡达尔教学医院从2014年2月28日至2014年5月1日。采用预试结构式问卷收集肠球菌感染的社会人口学资料和可能的相关因素。包括临床样本，包括尿液、血液、伤口拭子和医生要求在研究期间进行培养和抗菌药物敏感性试验的患者的其他体液。共有385名患者被纳入研究。使用SPSS 20版输入数据并进行分析。结果肠球菌感染率为6.2%（24/385），肠球菌感染率为1.2%（24/385）。最常见的感染部位是泌尿道，其次是伤口和血液。24株分离菌中，33.3%（8/24）对所有抗菌药物耐药。万古霉素耐药肠球菌（VRE）占肠球菌分离株的41.7%（10/24）。此外，三分之二的分离株是多药耐药（MDR）肠球菌。多因素分析显示，住院时间2天及2天以上者感染率为17/32（53.1%），既往任何抗生素史（AOR = 9.13; [95% CI; 2.01-41.51] P = 0.00）和导尿管插入史（AOR = 8.80; [95%CI; 1.70-45.64] P = 0.01）与肠球菌感染的发生率相关。伤口感染和脓毒症高于其他感染。从研究区域的临床样本中分离出包括VRE在内的多重耐药肠球菌。住院时间≥48 h、抗生素使用史、导尿史是肠球菌感染的相关因素。VRE的存在表明多药耐药肠球菌的抗生素治疗选择减少。因此，应加强对肠球菌感染的预防和多重耐药肠球菌的应急管理。此外，物种鉴定和抗生素抗性的先进和大规模的要求。
BackgroundEnterococci 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.MethodsA 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.ResultThe 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.ConclusionThe 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.