Epidemiology of Enterococcal Infections in Enugu State, Nigeria

Main Article Content

G. A. C. Ezeah
M. C. Ugwu
C. O. C. Ibe
O. C. Ike
A. O. Ekundayo

Abstract

Enterococci despite being a normal commensal is of great health concern since it can become virulent. Hence the study investigated the prevalence of Enterococci infection and two tertiary health institutions (Enugu State University of Technology (ESUT) Teaching Hospital, Parklane and University of Nigeria Teaching Hospital (UNTH), Ituku/Ozalla in Enugu State) were used. Isolation and identification were based on standard procedures and biochemical tests. The results showed that age ranges of 21-25years 10(14.7%) and 26-30 years 8(11.8%) had the highest prevalence. Also, more females were infected by the organism than males though the difference was not statistically significant (p= 0.371).The possible predisposing factor showed that 16(23.5%) were unknown while 10(14.7%), 6(8.8%), 14(20.6%), 9(13.2%), 8(11.8%) and 5(7.6%) were catheterization, surgery, pregnancy, Diabetes, HIV/AIDS and previous history of enterococcal infection, respectively. The frequency of enterococcal isolates from different specimens showed that 24(35.3%) of the isolates were from urine samples, 12(17.6%) were from high vaginal swab, 7(10.2%) were from ear swab and wound swab respectively, 4(5.9%) were from urethral swab and aspirates respectively and 2(2.9%) were from sputum samples. Furthermore, departmental sources of enterococcus sp. isolated showed that 21(30.9%) were from Surgery department followed by general out-patients department 14(20.6%), Urology 8(10.3%), Gynaecology 7(10.3), Medicine 6(8.8%), Antenatal, Children out-patients, Neurology and Children Emergency Department had 3(4.4%) each. Also, 41(60.3%) out of the 68 isolates were nosocomially acquired and 27(39.7%) isolates were community acquired. There was no significant difference (p= 0.486) when nosocomially acquired enterococcal isolates were compared with community acquired enterococcal isolates. Monthly frequencies of the isolates showed that July had the highest frequency 10(14.7%) followed by the month of May 7(10.3%). April, August and October had 6(8.8%) respectively. February, March November and December had 5(7.4) respectively; January and September had 4(5.9%) respectively while June had 3(4.4%). Seasonal comparison (rainy and dry season) of the distribution of the isolates within the years of the study showed that rainy season had 38 number of isolates while dry season had 30 number of isolates and there was no significant difference between the frequencies of occurrence in the two seasons (p= 0.271). Therefore, there is an increasing prevalence of Enterococci and can be hospital acquired, screening for this organism is important in hospital setting.

Keywords:
Enterococci, infection, prevelance, nosocomial

Article Details

How to Cite
Ezeah, G. A. C., Ugwu, M. C., Ibe, C. O. C., Ike, O. C., & Ekundayo, A. O. (2020). Epidemiology of Enterococcal Infections in Enugu State, Nigeria. Asian Journal of Research in Infectious Diseases, 5(1), 28-36. https://doi.org/10.9734/ajrid/2020/v5i130158
Section
Original Research Article

References

1. Agudelo Higuita NI, Huycke MM. Enterococcal Disease, Epidemiology, and Implications for Treatment. 2014 Feb 4. In: Gilmore MS, Clewell DB, Ike Y, et al., editors. Enterococci: From Commensals to Leading Causes of Drug Resistant Infection [Internet]. Boston: Massachusetts Eye and Ear Infirmary; 2014.
Available:https://www.ncbi.nlm.nih.gov/books/NBK190429. Retrieved 20/11/2019
2. Hidron AI, Edwards JR, Patel J, Horan TC, Sievert DM, Pollock DA, Fridkin SK. NHSN annual update: Antimicrobial-resistant pathogens associated with healthcare-associated infections: Annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007. Infection Control and Hospital Epidemiology. 2008;29(11):996–1011.
3. Weisberger L, Jamieson M. Clinical inquiries. How can you prevent arec urrence of diverticulitis? The Journal of family Practice. 2009;58(7):381-382.
4. Boyko EJ, Film SD, Scholes D, Chen CL, Normand EH, Yarbro P. Diabetes and the risk of acute urinary tract infection among menopausal women. Diabetes Care. 2002; 25:1778–1783.
5. Nester EW, Dennis GA, Evans RC, Nester PM. Microbiology: A human perspective. A. S. M. Press, Washington D. C. 2001;290-300.
6. Ellis AK. Quantity of life in women with UTI; is benign disease misnomer? Journal of American Board of Family Practice. 2000; 13(1):392-397.
7. Scholes D, Hooton TM, Roberts PL, Stapleton AE, Gupta K, Stain WE. Risk factors for recurrent urinary tract infections in young women. Journal of Infectious Diseases. 2000;182:1177–1182.
8. Saurander LB. Urinary tract infection in the aged – an epidemiological study. Annales Medicinae Internae Fenniae Supplement. 1966;4(5):7-55.
9. Ezeah GAC, Ugwu MC, Ekundayo AO, Odo OF, Ike OC, Akpe RA. Antibiotic Susceptibility Testing, Plasmid Detection and Curing of Clinically Isolated Enterococcus Species. Journal of Advances in Microbiology. 2019;16(3):1-20.
10. Gajdács M. The Concept of an Ideal Antibiotic: Implications for Drug Design. Molecules. 2019;24(892):1-16.
11. Andrew LK, Steven MM, William L, Ezyka H, Michael GC, Scott JH. Enterococcus faecalis Tropism for the kidneys in the urinary tract of C57BL/6J Mice. Infection and Immunity. 2005;73(4):2461-2468.
12. Tracy JE, Michael JG. Molecular Screening of Enterococcus Virulence Determinants and Potential for genetic exchange between Food and Medical Isolates. Applied and Environmental Microbiology. 2001;67(4):1628-1635.
13. Baker FJ, Silverton, Kilshaw. Introduction to medical laboratory Technology 5th ed. Butterworth. London. 1985;251-289.
14. Cheesbrough M. Collection and transportation of Specimens. Examination of specimens. 1n: Medical Laboratory Manual for Tropical Countries. Cambridge University press, UK. 1991;100-156.
15. Diana-Roxana P, Elena S, Mariana Carmen C, Ileana S, Ana-Maria N, Ionela A, Floarea S, Tatiana D. Isolation and identification of some Lactobacillus and Entercoccus strains by a polyphasic taxonomical approach. Romanian Biotechnological Letters. 2009;14(2):4225-4233.
16. Ekundayo AO, Ezeah GAC, Akpe RA, Odo OF, Ugwu MC, Ike OC, Amadi NC, Okuku CN. Prevalence and characterization of enterococcal infections in Enugu State, Nigeria. European Journal of Biomedical and Pharmaceutical Sciences. 2019;6(2): 32-49.
17. Odeyemi AT, Dada AC, Ogunbanjo OR, Ojo MA. Bacteriological, physicochemical and mineral studies on awedele spring water and soil samples in Ado Ekiti. African Journal of Environmental Science and Technology. 2010;4(6):319-327.
18. Kafayat OO, Solomon OF, Samuel ST. Prevalence ofhospital-acquired enterococci infections in two primary-care hospitals in osogbo, southwestern Nigeria. African Journal of Infectious Diseases. 2011; 5(2):40-46.
19. Pallares R, Pujol M, Pena C, Ariza J, Martin R, Gudiol F. Cephalosporins as a risk factor for nosocomial Enterococcus faecalis bacteremia. Archives of Internal Medicine. 1993;153:1581–1586.