Prevalence of Extended-Spectrum Beta-Lactamases-Producing Microorganisms in Patients Admitted at KRRH, Southwestern Uganda

Abstract

The emergence of extended-spectrum beta-lactamase- (ESBL-) producing pathogenic bacteria at Kabale Regional Referral Hospital (KRRH), located in southwestern Uganda, is of great concern: a phenomenon that worries clinicians and other healthcare workers due to the serious threat they pose to patients. This current study aimed at determining the phenotypic detection of ESBL-producing strains of E. coli, Klebsiella sp., and Proteus sp. isolated from clinical specimens and their prevalence in patients admitted at KRRH. We used combined disc diffusion technique to detect and establish the presence of ESBLs-producing bacteria. Of the 100 tested bacterial isolates, 89 (89%) were identified as ESBL-producing bacteria. Klebsiella sp. predominated in the samples (46 (52%)), presenting the highest frequency of ESBLs producing followed by E. coli (39 (44%)) and Proteus mirabilis (4 (4.5%)) from the combined disk diffusion.

Incidence and Etiology of Catheter Associated Urinary Tract Infection among Admitted Patients at Kabale Regional Referral Hospital, South Western Uganda

“…This may be attributable to the indiscriminate use of these antibiotics in empirical treatment of almost all ailments as well as use of some of these drugs (Cotrimoxazole) for prophylaxis in HIV infected individuals; thus bacteria are almost always exposed to such drugs which have led to resistance. The incidence of ESBL producing gram-negative bacteria dominated by Klebsiella pneumoniae (60%) and Escherichia coli (40%) in this study is in agreement with study findings by Baguma et al, (2017) indicating Klebsiella pneumoniae and Escherichia coli as the most ESBL producing bacteria [11].…”

“…There is a growing concern by Kabale Regional Referral Hospital clinical team about increased catheter related complications and high ESBL producing uropathogens which is a big challenge during patient management [11].…”

Resistance Patterns and Phenotypic Detection of β-lactamase Enzymes among Enterobacteriaceae Isolates from Referral Hospitals in Khartoum State, Sudan

“…A previous study at Khartoum state hospitals found that ESBL producer was 30.2% among E. coli [26]. A similar observation has been documented elsewhere [17]. For instances, a study from Burkina Faso reported ESBL producers were more often found in E. coli (67.5%) and K. pneumoniae (26%) [8].…”

“…Similar results have been reported in Sudan, where E. coli and K. pneumoniae were the most frequent pathogens recovered from urine samples [16]. Likewise, a study in Uganda reported that K. pneumoniae (52%) and E. coli (44%) were the most frequent Gram-negative organisms from patients' clinical specimens [17]. As well, global studies proved that infections caused by Gram-negative bacteria are predominant compared to other pathogens [18,19].…”

“…In the present study, ESBL-producing Enterobacteriaceae were detected in 45.2% of isolates. This proportion was lower than those reported in Uganda (89%), and Brazil (61.1%), but relatively higher than 41% determined in the United Arab of Emirates [17,23,24]. It is well known that the use of expanded-spectrum cephalosporins in the hospital setting influences the selection of ESBLproducing organisms [25].…”