Epidemiology of Enterococcal Infections in Enugu State, Nigeria

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.