{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:01:26Z","timestamp":1787022086194,"version":"build-2736575974"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T00:00:00Z","timestamp":1624492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The emergence of vancomycin resistant Enterococci (VRE) has alarmed the global community due to its tendency for colonization of the gastrointestinal tract. Human Immunodeficiency Virus (HIV) patients are colonized by vancomycin resistant Enterococci than other groups. The aim of this study was to determine the incidence of vancomycin resistant Enterococci and its associated factors among HIV infected patients on Anti-Retroviral Therapy (ART).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Institution based cross sectional study was conducted among HIV infected patients on ART at from June 1 to August 30, 2020. Socio-demographic and clinical data were collected by pre-tested structured questionnaire. Stool sample was collected and processed by standard microbiological techniques. Kirby Bauer Disc diffusion method was used to perform antimicrobial susceptibility testing. Data were entered by Epi data version 4.6.0.2 and analyzed by SPSS version 25. Bivariable and multivariable logistic regression model was used to analyze the association between dependent and independent variables. P-values in the multivariable analysis, adjusted odds ratio (AOR) and 95% confidence interval (CI) were used to determine the strength of association. P-value \u22640.05 was considered as significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Enterococci<\/jats:italic>\n                      spp was isolated on 123\/200 (61.50%) patients. Among these isolates, the incidence of vancomycin resistant Enterococci was 11.4% [95% CI: (6.0\u201317.0)]. Antimicrobial susceptibility patterns against\n                      <jats:italic>Enterococci<\/jats:italic>\n                      showed highest rate of resistance to ampicillin (69.9%). Multidrug resistances were observed in 49.59% of\n                      <jats:italic>Enterococci<\/jats:italic>\n                      isolates. Study participants who had prior antibioticexposurer more than two weeks [AOR = 7.35; 95% CI: (1.2144.64)] and hospitalization for the last six months [AOR = 5.68; 95% CI: (1.09 29.74)] were significantly associated with vancomycin resistant\n                      <jats:italic>Enterococci<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In our study high incidence of vancomycin resistant\n                      <jats:italic>Enterococci<\/jats:italic>\n                      was found. Previous exposure to antibiotics for more than two weeks and hospitalization for more than six months were significantly associated with vancomycin resistant\n                      <jats:italic>Enterococci<\/jats:italic>\n                      . The isolated\n                      <jats:italic>Enterococci<\/jats:italic>\n                      had variable degrees of resistance to commonly prescribed antibiotics. Therefore, periodic surveillance on antimicrobial resistance pattern, adhering to rational use of antibiotics and implementing infection prevention protocols may reduce colonization by VRE.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0251727","type":"journal-article","created":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T13:41:26Z","timestamp":1624542086000},"page":"e0251727","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Vancomycin resistant Enterococci and its associated factors among HIV infected patients on anti-retroviral therapy in Ethiopia"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7653-3685","authenticated-orcid":true,"given":"Belayneh","family":"Regasa Dadi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zerihun","family":"Solomon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mheret","family":"Tesfaye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,6,24]]},"reference":[{"key":"pone.0251727.ref001","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1590\/S0074-02762012000100008","article-title":"Risk factors for vancomycin-resistant enterococci colonisation in critically ill patients","volume":"107","author":"DW Batist\u00e3o","year":"2012","journal-title":"Mem Inst Oswaldo Cruz"},{"key":"pone.0251727.ref002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2018\/7510157","article-title":"Magnitude of Vancomycin-Resistant Enterococci (VRE) Colonization among HIV-Infected Patients Attending ART Clinic in West Amhara Government Hospitals","author":"M Agegne","year":"2018","journal-title":"Int J Microbiol"},{"key":"pone.0251727.ref003","article-title":"Global Priority List of Antibiotic-Resistant Bacteria to Guide Research, Discovery, and","author":"E. Tacconelli","year":"2017","journal-title":"Development of New Antibiotics. WHO"},{"issue":"4","key":"pone.0251727.ref004","first-page":"277","article-title":"The Antibiotic Resistance Crisis: Part 1: Causes and Threats","volume":"40","author":"CL Ventola","year":"2015","journal-title":"P T"},{"key":"pone.0251727.ref005","doi-asserted-by":"crossref","first-page":"340","DOI":"10.4103\/0366-6999.198923","article-title":"Emergence of Vancomycin-resistant Enterococci at a Teaching Hospital, Saudi Arabia","volume":"130","author":"FE Alotaibi","year":"2017","journal-title":"Chin Med J (Engl)."},{"key":"pone.0251727.ref006","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1007\/s10096-016-2702-0","article-title":"Prevalence of vancomycin-resistant Enterococcus in Iran: a systematic review and meta-analysis","volume":"35","author":"M Emaneini","year":"2016","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"1","key":"pone.0251727.ref007","doi-asserted-by":"crossref","first-page":"ofw246","DOI":"10.1093\/ofid\/ofw246","article-title":"Colonization With Vancomycin-Resistant Enterococci and Risk for Bloodstream Infection Among Patients With Malignancy: A Systematic Review and Meta-Analysis","volume":"4","author":"M Alevizakos","year":"2016","journal-title":"Open Forum Infect Dis"},{"issue":"4","key":"pone.0251727.ref008","first-page":"223","article-title":"Vancomycin Resistant Enterococcal Infections: Background, Pathophysiology, Epidemiology","volume":"97","author":"L Susan","year":"2018","journal-title":"Medscape"},{"key":"pone.0251727.ref009","volume-title":"Medical microbiology","author":"PR Murray","year":"2016","edition":"8"},{"key":"pone.0251727.ref010","first-page":"16959","article-title":"Vancomycin resistant enterococci in farm animals\u2013occurrence and importance","volume":"2","author":"O. Nilsson","year":"2012","journal-title":"Infect Ecol Epidemiol"},{"key":"pone.0251727.ref011","first-page":"111","article-title":"Enterococcal infections & antimicrobial resistance","volume":"128","author":"S Sood","year":"2008","journal-title":"Indian J Med Res"},{"key":"pone.0251727.ref012","doi-asserted-by":"crossref","first-page":"217","DOI":"10.2147\/IDR.S54125","article-title":"Vancomycin-resistant enterococcal infections: epidemiology, clinical manifestations, and optimal management","volume":"8","author":"C Crank","year":"2015","journal-title":"Infect Drug Resist"},{"key":"pone.0251727.ref013","volume-title":"Jawetz, Melnick & Adelberg\u2019s medical microbiology","author":"KC Carroll","year":"2016","edition":"27"},{"key":"pone.0251727.ref014","doi-asserted-by":"crossref","first-page":"2436","DOI":"10.1128\/JCM.00211-16","article-title":"Resistance Mechanisms, Epidemiology, and Approaches to Screening for Vancomycin-Resistant Enterococcus in the Health Care Setting","volume":"54","author":"ML Faron","year":"2016","journal-title":"J Clin Microbiol"},{"key":"pone.0251727.ref015","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1186\/s12879-019-4136-7","article-title":"Species, antibiotic susceptibility profiles and van gene frequencies among enterococci isolated from patients at Mulago National Referral Hospital in Kampala, Uganda","volume":"19","author":"DP Kateete","year":"2019","journal-title":"BMC Infect Dis"},{"key":"pone.0251727.ref016","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2018\/4753460","article-title":"Vancomycin-Resistant Enterococci and Its Associated Risk Factors among HIV-Positive and -Negative Clients Attending Dessie Referral Hospital, Northeast Ethiopia","author":"S Ali","year":"2018","journal-title":"Int J Microbiol"},{"issue":"1","key":"pone.0251727.ref017","doi-asserted-by":"crossref","first-page":"531","DOI":"10.22207\/JPAM.13.1.59","article-title":"Phenotypic Investigation of Vancomycin, Teicoplanin and Linezolid Resistance Among Enterococcus spp. Isolated from Children Diarrhea","volume":"13","author":"HOM Al-Dahmoshi","year":"2019","journal-title":"J Pure Appl Microbiol"},{"key":"pone.0251727.ref018","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1186\/1471-2458-14-185","article-title":"Prevalence of vancomycin resistant Enterococci and associated risk factors among clients with and without HIV in Northwest Ethiopia: a cross-sectional study","volume":"14","author":"W Abebe","year":"2014","journal-title":"BMC Public Health"},{"key":"pone.0251727.ref019","first-page":"89","article-title":"Risk factors for intestinal colonization with vancomycin resistant enterococci\u2019 A prospective study in a level III pediatric intensive care unit","volume":"28","author":"R Amberpet","year":"2018","journal-title":"J Lab Physicians"},{"key":"pone.0251727.ref020","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s13099-018-0259-4","article-title":"Gut colonization with vancomycin-resistant Enterococcus and risk for subsequent enteric infection","volume":"10","author":"JE Axelrad","year":"2018","journal-title":"Gut Pathog"},{"issue":"9\/10","key":"pone.0251727.ref021","article-title":"Emergence of vancomycin-resistant enterococci in South Africa: Implications for public health","volume":"114","author":"FE Tatsing Foka","year":"2018","journal-title":"South Afr J Sci"},{"key":"pone.0251727.ref022","first-page":"485","article-title":"Vancomycin resistant enterococci healthcare associated infections","volume":"25","author":"GB Orsi","year":"2013","journal-title":"Ann Ig"},{"issue":"5","key":"pone.0251727.ref023","article-title":"Drug-Resistant Bacterial Infections in HIV Patients","volume":"98","author":"MR Rameshkumar","year":"2018","journal-title":"Intech Open"},{"key":"pone.0251727.ref024","first-page":"73","article-title":"Antibiotic Sensitivity Patterns Among Postmortem Bacterial Isolates From HIV-Infected Patients in Western Kenya: A Cross-sectional Descriptive Study","volume":"3","author":"C Kwobah","year":"2015","journal-title":"J Dis Glob Health."},{"issue":"1","key":"pone.0251727.ref025","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.jiph.2019.06.015","article-title":"Changing antibiotic resistance profile of Staphylococcus aureus isolated from HIV patients (2012\u20132017) in Southern India","volume":"13","author":"RS Chinnambedu","year":"2020","journal-title":"J Infect Public Health"},{"key":"pone.0251727.ref026","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s13756-018-0353-x","article-title":"Continuous increase of vancomycin resistance in enterococci causing nosocomial infections in Germany-10 years of surveillance","volume":"7","author":"C Remschmidt","year":"2018","journal-title":"Antimicrob Resist Infect Control"},{"key":"pone.0251727.ref027","unstructured":"Census 2007. Southern Peoples, Nations and Nationalities Region Archived November 13, 2012, at the Way back Machine."},{"key":"pone.0251727.ref028","first-page":"9","article-title":"Practical Issues in Calculating the Sample Size for Prevalence Studies","volume":"1","author":"L Naing","year":"2006","journal-title":"Arch Orof Sci"},{"key":"pone.0251727.ref029","unstructured":"Bile Esculin Azide Agar ISO Formato 30 Plates [Internet]. [cited 2021 Jan 24]."},{"key":"pone.0251727.ref030","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing","author":"Clinical and Laboratory Standards Institute","year":"2018","edition":"28"},{"key":"pone.0251727.ref031","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1186\/s13104-018-3898-0","article-title":"Prevalence and antimicrobial susceptibility pattern of Enterococcus species isolated from different clinical samples at Black Lion Specialized Teaching Hospital, Addis Ababa, Ethiopia","volume":"11","author":"ZT Ferede","year":"2018","journal-title":"BMC Res Notes"},{"key":"pone.0251727.ref032","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1186\/s13756-019-0594-3","article-title":"The rise in vancomycin-resistant Enterococcus faecium in Germany: data from the German Antimicrobial Resistance Surveillance (ARS)","volume":"8","author":"R Markwart","year":"2019","journal-title":"Antimicrob Resist Infect Control"},{"key":"pone.0251727.ref033","doi-asserted-by":"crossref","first-page":"155","DOI":"10.3855\/jidc.3018","article-title":"Prevalence of multidrug-resistant enterococci in a tertiary care hospital in Mumbai, India","volume":"7","author":"VR Deshpande","year":"2013","journal-title":"J Infect Dev Ctries"},{"key":"pone.0251727.ref034","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.ijantimicag.2017.01.008","article-title":"Vancomycin-resistant enterococci colonisation, risk factors and risk for infection among hospitalised paediatric patients: a systematic review and meta-analysis","volume":"49","author":"ME Flokas","year":"2017","journal-title":"Int J Antimicrob Agents"},{"issue":"4","key":"pone.0251727.ref035","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1093\/jac\/dks469","article-title":"Twenty-five years of shared life with vancomycin-resistant enterococci: is it time to divorce?","volume":"68","author":"V Cattoir","year":"2013","journal-title":"J Antimicrob Chemother"},{"key":"pone.0251727.ref036","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1086\/499391","article-title":"Prevalence of and Risk Factors for Colonization With Vancomycin-Resistant Enterococcus Among Human Immunodeficiency Virus\u2013Positive Outpatients","volume":"27","author":"C Achenbach","year":"2006","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"2","key":"pone.0251727.ref037","doi-asserted-by":"crossref","first-page":"121","DOI":"10.21010\/ajid.v10i2.8","article-title":"Surveillance for vancomycin resistant enterococci in a tertiary institution in south western Nigeria","volume":"10","author":"AE Ekuma","year":"2016","journal-title":"Afr J Infect Dis"},{"key":"pone.0251727.ref038","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s13756-019-0466-x","article-title":"Emergence of vancomycin-resistant enterococci in Switzerland: a nation-wide survey","volume":"8","author":"N Buetti","year":"2019","journal-title":"Antimicrob Resist Infect Control"},{"key":"pone.0251727.ref039","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1186\/s12879-017-2363-3","article-title":"Isolation of enterococci, their antimicrobial susceptibility patterns and associated factors among patients attending at the University of Gondar Teaching Hospital","volume":"17","author":"A Yilema","year":"2017","journal-title":"BMC Infect Dis"},{"issue":"1","key":"pone.0251727.ref040","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1186\/s13104-015-1200-2","article-title":"Antimicrobial resistance profile of Enterococcus species isolated from intestinal tracts of hospitalized patients in Jimma, Ethiopia","volume":"8","author":"A Abamecha","year":"2015","journal-title":"BMC Res Notes"},{"key":"pone.0251727.ref041","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1186\/s13104-018-3382-x","article-title":"Prevalence and phenotypic characterization of Enterococcus species isolated from clinical samples of pediatric patients in Jimma University Specialized Hospital, south west Ethiopia","volume":"11","author":"M Toru","year":"2018","journal-title":"BMC Res Notes"},{"issue":"2","key":"pone.0251727.ref042","doi-asserted-by":"crossref","DOI":"10.5812\/pedinfect.37680","article-title":"Diabetic Foot Infections: Antibiotic Susceptibility Patterns and Determination of Antibiotic Cross-Resistance in Clinical Isolates of Enterococcus Species During 2012\u20132014 in Shiraz, Iran","volume":"5","author":"M Anvarinejad","year":"2016","journal-title":"Arch Pediatr Infect Dis"},{"issue":"1","key":"pone.0251727.ref043","doi-asserted-by":"crossref","first-page":"57","DOI":"10.7883\/yoken.65.57","article-title":"Healthcare-associated risk factors of vancomycin-resistant Enterococci colonization among outpatients undergoing hemodialysis","volume":"65","author":"SY Kee","year":"2012","journal-title":"Jpn J Infect Dis"},{"issue":"3","key":"pone.0251727.ref044","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1590\/S1517-838246320140403","article-title":"Healthcare-associated vancomycin resistant Enterococcus faecium infections in the Mansoura University Hospitals intensive care units, Egypt","volume":"46","author":"D Moemen","year":"2015","journal-title":"Braz J Microbiol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0251727","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,5]],"date-time":"2023-11-05T03:42:33Z","timestamp":1699155753000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0251727"}},"subtitle":[],"editor":[{"given":"Iddya","family":"Karunasagar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,6,24]]},"references-count":44,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0251727","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,24]]}}}