Carbapenem-resistant Enterobacteriaceae in patients with bacteraemia at tertiary hospitals in South Africa, 2015 to 2018

Perovic, Olga; Ismail, Husna; Quan, Vanessa; Bamford, Colleen; Nana, Trusha; Bhola, Prathna; Ramjathan, Praksha; Swe-Han, Khine Swe; Wadula, Jeannette; Whitelaw, Andrew; Smith, Melissa; Mbelle, Nontombi Marylucy; Singh-Moodley, Ashika; Germs-Sa, for

doi:10.1007/s10096-020-03845-4

Cited by 39 publications

(44 citation statements)

References 24 publications

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“…Among the ve genes which were detected by multiplex PCR, the most encountered gene was OXA-48like at a genotypic frequency of 36.4%. This corroborates well with recent studies which documented OXA-48-like gene and its variants as the most prevalent genes [27,31,33,35]. OXA-48.…”

Section: Discussionsupporting

confidence: 93%

“…and 89% to Ertapenem [30,31]. In comparison with previous studies at MNRH [23] and MBRRH [25] this study shows that the prevalence of carbapenem resistance in Uganda is on the rise and this is terrifying as recent meta-analyses revealed a substantial correlation between carbapenem resistant infections and increased risk of death [32].…”

Section: Discussionsupporting

confidence: 43%

“…Through molecular characterization, we detected carbapenem genotypic resistance frequency ranging from 32.4% at KIU-TH to 70.8% at MRRH and overall genotypic resistance prevalence of 43.2% in Uganda. In contrast, the overall genotypic prevalence was lower than that reported in Tunisia (86.3%) [33], Egypt (56%) [27], South Africa (86.0%), [31], India (76.3%) [34]. Among the ve genes which were detected by multiplex PCR, the most encountered gene was OXA-48like at a genotypic frequency of 36.4%.…”

Section: Discussionmentioning

confidence: 81%

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Prevalence of Pathogenic Klebsiella Pneumoniae based on PCR Capsular Typing Harbouring Carbapenemases Encoding Genes in Ugandan Tertiary Hospitals

Ssekatawa

Byarugaba

Nakavuma

et al. 2020

Preprint

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Background: Klebsiella pneumoniae is an opportunistic pathogen that has been implicated as one of commonest cause of hospital and community acquired infections. The K. pneumoniae infections have considerably contributed to morbidity and mortality in patients with protracted ailments. The capacity of K. pneumonia to cause diseases depends on presence of an array virulent factors. Coexistence and expression of virulent factors and genetic determinants of antibiotic resistance complicates treatment outcomes. Thus, emergence of pathogenic MDR K. pneumoniae poses a great threat to the healthcare system. However, the carriage of antibiotic resistance among pathogenic K. pneumoniae is yet to be investigated in Uganda. We sought to investigate the carbapenem resistance profiles and pathogenic potential based on capsular serotypes of K. pneumoniae clinical isolates. Methods: This was a cross sectional study involving use of archived Klebsiella pneumoniae isolates collected between January and December, 2019 at four tertiary hospitals in Uganda. All isolates were subject to antimicrobial susceptibility assays to determine phenotypic antibiotic resistance, pentaplex PCR to detect carbapenemases encoding genes and heptaplex PCR to identify capsular serotypes K1, K2, K3, K5, K20, K54 and K57.Results: The study found an overall phenotypic carbapenem resistance of 23.3% (53/227) and significantly higher genotypic resistance prevalence of 43.1% (98/227). Over all, the most prevalent gene was blaOXA-48-like (36.4%), followed by blaIMP-type (19.4%), blaVIM-type (17.1), blaKP-type (14.0%) and blaNDM-type (13.2%). blaVIM-type and blaOXA-48-like conferred phenotypic resistance in all isolates and 38.3% isolates that harbored them respectively. Capsular multiplex PCR revealed that 46.7% (106/227) isolates were pathogenic and the predominantly prevalent pathotype was K5 (18.5%) followed by K20 (14.1%), K3 (7.1%), K2 (3.1%) and K1 (2.2%). Of the 106 capsular serotypes, 37 expressed phenotypic resistance; thus, 37 of the 53 carbapenem resistant K. pneumoniae were pathogenic.Conclusion: The high prevalence of virulent and antibiotic resistant K. pneumoniae among clinical isolates obtained from the four tertiary hospital as revealed by this study pose a great threat to healthcare. Our findings underline the epidemiological and public health risks and implications of this pathogen.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 43%

Section: Discussionmentioning

confidence: 81%

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Prevalence of Pathogenic Klebsiella Pneumoniae based on PCR Capsular Typing Harbouring Carbapenemases Encoding Genes in Ugandan Tertiary Hospitals

Ssekatawa

Byarugaba

Nakavuma

et al. 2020

Preprint

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“…This genotypic carbapenem resistance prevalence corroborates with earlier studies conducted in the East African region [18,25,38] and elsewhere [27,39] that reported levels ranging from 25% to 40%. Contrary, this frequency is signi cantly lower than carbapenem genotypic levels reported by studies in Tunisia (76.7%) [40], South Africa (68% and 86%) [33,34] , Egypt (89.6%) [37], Turkey (49.5%) [41]. KPC, VIM, NDM, OXA-48 and IMP are the commonest carbapenemases worldwide [42].…”

Section: Discussionmentioning

confidence: 77%

“…For example, prevalence of carbapenem resistance in Tanzania was 24% [25], Nigeria 15.2%, 27.4% and 36.8%) [26][27][28], India 31.77% [29]. Contrary, this frequency is higher than carbapenem resistance levels reported in countries like Ghana (7.2%) [30], Morocco 5.99% [31], and Ethiopia 2.73%, [32] with similar healthcare settings but lower than the incidences above 50% reported in South Africa, Egypt and Tunisia [33][34][35][36][37].…”

Section: Discussionmentioning

confidence: 91%

Carbapenem resistance profiles of Pathogenic Escherichia coli in Uganda

Ssekatawa

Byarugaba

Nakavuma

et al. 2020

Preprint

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Background: Escherichia coli has been implicated as one of the main etiological agents of diarrhea, urinary tract infections, meningitis and septicemia worldwide. The ability to cause diseases is potentiated by presence of virulence factors. The virulence factors influence the capacity of E. coli to infect and colonize different body systems. Thus, pathogenic E. coli are grouped into DEC strains that are mainly clustered in phylogenetic group B1 and A; ExPEC belonging to A, B2 and D. Coexistence of virulence and beta-lactamase encoding genes complicates treatment outcomes. Therefore, this study aimed at presenting the CR profiles among pathogenic E. coli. Methods: This was a retrospective cross-sectional study involving use of archived E. coli clinical isolates collected in 2019 from four Ugandan tertiary hospitals. The isolates were subjected to antibiotics sensitivity assays to determine phenotypic resistance. Four sets of multiplex PCR were performed to detect CR genes, DEC pathotypes virulent genes, ExPEC PAI and the E. coli phylogenetic groups. Results:Antibiotic susceptibility revealed that all the 421 E. coli isolates used were MDR as they exhibited 100% resistance to more than one of the first-line antibiotics. The study registered phenotypic and genotypic CR prevalence of 22.8% and 33.0% respectively. The most predominant gene was blaOXA-48 with genotypic frequency of 33.0%, then blaVIM(21.0%), blaIMP(16.5%), blaKPC(14.8%) and blaNDM(14.8%). Spearman’s correlation revealed that presence of CR genes was highly associated with phenotypic resistance. Furthermore, of 421 MDR E. coli isolates, 19.7% harboured DEC virulent genes, where EPEC recorded significantly higher prevalence (10.8%) followed by S-ETEC(3.1%), STEC(2.9%), EIEC (2.0%) and L-ETEC(2.0%). Genetic analysis characterized 46.1% of the isolates as ExPEC and only PAI IV536(33.0%) and PAI IICFT073(13.1%) were detected. Phylogenetic group B2 was predominantly detected (41.1%), followed by A(30.2%), B1(21.6%), and D(7.1%). Furthermore, 38.6% and 23.1% of the DEC and ExPEC respectively expressed phenotypic resistance.Conclusion: Our results exhibited significant level of CR carriage among the MDR DEC and ExPEC clinical isolates belonging to phylogenetic groups B1 and B2 respectively. Virulence and CR genetic factors are mainly located on mobile elements. Thus, constitutes a great threat to the healthcare system as it promotes horizontal gene transfer.

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The Current Status of Antibiotic-Resistant Bacteria and Resistance Genes in African Aquaculture

Limbu

2023

Antimicrobial Research and One Health in Africa

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Carbapenem-resistant Enterobacteriaceae in patients with bacteraemia at tertiary hospitals in South Africa, 2015 to 2018

Cited by 39 publications

References 24 publications

Prevalence of Pathogenic Klebsiella Pneumoniae based on PCR Capsular Typing Harbouring Carbapenemases Encoding Genes in Ugandan Tertiary Hospitals

Prevalence of Pathogenic Klebsiella Pneumoniae based on PCR Capsular Typing Harbouring Carbapenemases Encoding Genes in Ugandan Tertiary Hospitals

Carbapenem resistance profiles of Pathogenic Escherichia coli in Uganda

The Current Status of Antibiotic-Resistant Bacteria and Resistance Genes in African Aquaculture

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Carbapenem-resistant Enterobacteriaceae in patients with bacteraemia at tertiary hospitals in South Africa, 2015 to 2018

Cited by 39 publications

References 24 publications

Prevalence of Pathogenic Klebsiella Pneumoniae based on PCR Capsular Typing Harbouring&nbsp;Carbapenemases Encoding Genes in Ugandan Tertiary Hospitals

Prevalence of Pathogenic Klebsiella Pneumoniae based on PCR Capsular Typing Harbouring&nbsp;Carbapenemases Encoding Genes in Ugandan Tertiary Hospitals

Carbapenem resistance profiles of Pathogenic Escherichia coli in Uganda

The Current Status of Antibiotic-Resistant Bacteria and Resistance Genes in African Aquaculture

Contact Info

Product

Resources

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Prevalence of Pathogenic Klebsiella Pneumoniae based on PCR Capsular Typing Harbouring Carbapenemases Encoding Genes in Ugandan Tertiary Hospitals

Prevalence of Pathogenic Klebsiella Pneumoniae based on PCR Capsular Typing Harbouring Carbapenemases Encoding Genes in Ugandan Tertiary Hospitals