Mettu University, Ethiopia
Abdulhakim Abamecha completed his Master’s Degree in Medical Microbiology (Bacterial Drug Resistance) at College of Public Health and Medical Sciences, Jimma University in 2013. Currently, he is a PhD scholar in Tropical and Infectious Diseases and his thesis entitled “Molecular surveillance of K13-propeller gene polymorphisms and automated blood smear analysis for mobile malaria diagnosis using deep learning in Southwest Ethiopia” at Jimma University, Jimma, Ethiopia and academic Staff of Faculty of Public Health and Medical Sciences, Mettu University, Ethiopia. He is the author of several articles published in peer-reviewed journal.
Background & Aim: During last two decades, there has been a world-wide trend in increasing occurrence of enterococcal infections in the hospitals. Despite worldwide increasing rate of drug resistant enterococci colonization and infection among hospitalized patients, there is scarcity of data from resource limited setting. The present study aimed at determining the spectrum of enterococcal infections, species prevalence, antimicrobial resistance and characteristics of vancomycin resistant enterococci (VRE) in Mettu Referal Hospital, Southwestern, Ethiopia.
Materials & Methods: Between January 2015 and July 2015, Enterococcus species were obtained from clinical samples. Enterococci were identified using standard biochemical tests. Antimicrobial susceptibility was tested by Kirby-Bauer disk diffusion according to Clinical & Laboratory Standards Institute (CLSI) guidelines. VRE agar base was used to screen VRE isolates. Minimum inhibitory concentration (MIC) values of VRE isolates were determined using Epsilometer-test. VRE isolates were also examined by PCR to detect vanA gene.
Results: From 325 clinical samples, 40 (12.3%) enterococcal isolates were obtained. Most common species isolated was E. faecalis (72.6%) followed by E. faecium (26.7%). Majority of enterococcal infections were detected from medical and surgical wards and clinically presented as UTIs. Disk diffusion method showed 62.1% were resistant to penicillin, 59.5% ampicillin, 34.5% ciprofloxacin, 34.7% high-level gentamicin, 32.8% high-level streptomycin, 2.6% teicoplanin and none to linezolid. Three (7.5%) enterococcal isolates were vancomycin resistant in VRE screen and disk diffusion method. Epsilometer-test of VRE isolates showed two (5%) isolates were resistant and one (2.5%) was intermediately resistant. From three VRE isolates, two showed VanA and one VanB phenotypes and the two VanA phenotypes had vanA gene cluster.
Conclusion: This study reveals the emergence of vancomycin resistance enterococci strains. Thus, periodic surveillance of antibacterial susceptibilities is recommended to detect emerging resistance and to prevent the spread of antibacterial-resistant strains. Besides, more accurate and reliable MIC determination tests should be performed in all suspected VRE isolates. Confirmatory PCR is required for identifying resistant gene cluster.