Intestinal colonisation of vancomycin-resistant enterococci among patients with cancer at Jimma University Medical Center, Ethiopia: A comparative cross-sectional study

Objective: Vancomycin-resistant enterococci (VRE) pose a major threat in hospital settings. Patients with cancer are at a higher risk of hospital-acquired infections such as VRE. This study aimed to determine the intestinal colonisation rate of VRE in patients with cancer at Jimma University Medical Center, southwest Ethiopia. Methods: A comparative cross-sectional study was conducted prospectively from April to September 2021 at Jimma University Medical Center on 113 patients with cancer. An equal number of apparently healthy individuals were included for comparison. Stool samples were collected from both patients with cancer and apparently healthy individuals, then cultured on bile esculin azide agar. Vancomycin resistance was determined by minimum inhibitory concentration and disk diffusion method, whereas antibiotic susceptibility to other antibiotics was performed by disk diffusion method. Data were entered into Epidata v. 4.6.0.6 and analysed by SPSS v. 26. Results: The overall colonisation rate of Enterococcus species was 76.9% (87/113) in patients with cancer and 80.5% (91/113) in apparently healthy individuals, with no statistically significant difference. However, the intestinal colonisation rate of VRE was higher in patients with cancer (12.6%; 11/87) compared with apparently healthy individuals (4.4%, 4/91). VRE isolates showed the highest resistance to tetracycline (66.7%) and the lowest resistance to chloramphenicol (13.3%). Multidrug resistance was observed in more than half (66.7%; 10/15) of the VRE isolates. Conclusions: The intestinal colonisation rate by VRE was higher in patients with cancer compared with healthy individuals. Regular screening for VRE colonisation, along with improved infection-prevention practices, are vital to reduce the risk of VRE infections. (c) 2024 The Author(s). Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)