Prevalence of vancomycin resistant enterococci Colonization and associated risk factors among HIV Infected people at mettu karl comprehensive specialized Hospital, southwest Ethiopia: a comparative cross Sectional study

Abstract

Background: Vancomycin resistant enterococci (VRE) poses a major public health problem worldwide. The majority of Vancomycin resistant enterococci (VRE) colonization occurs in the gastrointestinal (GI) the skin, in the genitourinary (GU) tract, and oral cavity. The gastrointestinal (GI) colonization of Vancomycin resistant Enterococci persist for months to years and efforts to decolonization are transitory, with recurrence days or weeks later. In immunosuppressed people including HIV patients VRE causes a clinical illness. Moreover, VRE has significant contribution for nosocomial infections. Therefore, the investigation of burden of VRE colonization among HIV positive people in various clinical settings is crucially important. Objective: To determine the prevalence of VRE colonization and associated risk factors among HIV positive people at Mettu Karl Comprehensive Specialized Hospital. Methods: A comparative cross sectional study was conducted from July to September 2022. A total of 308 study participants were enrolled. Socio-demographic and clinical data were collected using structured questionnaire and checklist. The enterococci were isolated and identified from stool specimen using standard bacteriological procedures. The antimicrobial susceptibility test was performed by using the Kirby–Bauer disc diffusion method. Data was entered using Epi Data version 3.1 and analyzed using SPSS version-26 software package. Descriptive analysis was used to visualize differences with in data. Moreover, the stepwise logistic regression model was done to assess factors associated with VRE colonization. P value was set at < 0.05 to indicate statistical significance difference. Result: The overall colonization of enterococci was 56.8 %( 175/308) of which 9.1 %( 16/175) were VRE. The prevalence of VRE among HIV positive was 11(11.2%) whereas it was 5(6.5%) in HIV negative people. Moreover the overall prevalence of multiple drug resistance (MDR) Enterococci was found to be 46.9%. Antibiotic treatment for ≥ two weeks (AOR=20.329; (95% CI: 1.092-378.369) (p value=.043)) and hospitalization in the last six months (AOR=11.913, (95% CI: 1.250-113.508) (p value=0.031)) have showed statistically significant association with VRE colonization. Conclusion: The overall GIT colonization of vancomycin resistant Enterococci among HIV positive people was high. More than two weeks exposure to antibiotics and hospitalization in the last six months were significant factors for VRE colonization. Therefore, strict implementation of drug control among HIV people should be implemented.