TITLE:
Antibiotic Resistance Profile of Enterococcus faecalis and Enterococcus faecium Isolates from Urine and Pleural Fluid in Two Hospitals of Cameroon
AUTHORS:
Cécile Ingrid Djuikoue, Farid Wega, Grace Yemina Kombeu, Cedric Seugnou Nana, Christiane Possi Kiyang, Lussabella Pohoko Medzam, Erica Megane Noubissi Makougoum, Nellie Mbianga Nkuigoua, Herman Koyouo Tagne, Mérimé Joël Tchinda Talokou, Yvonne Valérie Yolande Mavoungou, Ashu Michel Agbor
KEYWORDS:
Enterococcus faecalis, Enterococcus faecium, Healthcare-Associated Infections, Antimicrobial Resistance, Cameroon
JOURNAL NAME:
Open Journal of Medical Microbiology,
Vol.14 No.1,
March
28,
2024
ABSTRACT: Enterococcus faecalis and Enterococcus faecium rank among the leading causes
of nosocomial bacteremia and urinary tract infections. They often persist on
hospital surfaces due to their ability to withstand adverse environmental conditions
(low or high temperatures, high pH, and high salinity). The global Enterococcus faecalis-Enterococcus faecium ratio is currently shifting towards Enterococcus faecium. Enterococci present variable levels of resistance to certain
families of antibiotics. This is the case for
aminoglycosides, beta-lactams and cephalosporins. In 2017, WHO ranked Enterococci among priority pathogens for
research and development of new antibiotics. The objective of our study was to
determine the antibiotic resistance profile of Enterococcus faecalis and Enterococcus faecium isolates from urine and pleural fluid in two hospitals in Cameroon. This cross-sectional and analytic study was carried out
between June to August 2023 on hospitalized and day patients in which a
cytobacteriological test of urine and pleural fluid was done. The samples were inoculated on CLED Agar for
urine and on Chocolate + polyvitex and blood agar (prepared from Columbia agar)
for pleural fluid samples and incubated at 37℃for 18 to 24 hours.
Identification of isolates was carried out using the API 20 STREP micro gallery
(Biomerieux, France) and tested for antimicrobial susceptibility. The data on
socio-demographical and potential risk factors were recorded using
self-administered questionnaires and data from laboratory analyses of the specimen
were collected in a data capture sheet. Potential risk factors associated with the
presence of Enterococci, were
evaluated using the logistic regression in univariate and multivariate
analysis. P value < 0.05 was considered as significant. A total of 511
patients were recruited who were predominantly females. Enterococcus spp were isolated
in 27.79% of our samples with Enterococcus faecalis mostly encountered. Enterococcus spp showed a high level of resistance to penicilline (99.3%
to Ampicilline), macrolides (66.2% to Erythromycin) and cyclines (85.2% to
Doxycycline). Hospitalisation, access to health facilities, contact with urine
specimen and hand hygiene practices were risk factors related to infection with Enterococcus spp while hospitalisation, health facility and hand hygiene were related to glycopeptide resistant Enterococcus.
Strict compliance with hygiene rules and appropriate antibiotic consumption
could help in the fight against these infections.