Carbapenemase-producing Gram-negative bacteria: An emerging threat to health care in Africa

Aliyu, Shamsudin

doi:10.4103/0331-3131.119978

Cited by 6 publications

(4 citation statements)

References 13 publications

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“…Medical tourism has now resulted in patients acquiring these resistant bacteria in countries outside the continent and bringing them back to African hospitals. 31 Our study conducted on all clinical specimen from different outpatient and inpatients sent for routine culture at HUCSH and only included for the study if gram negative bacteria isolated.…”

Section: Discussionmentioning

confidence: 99%

Phenotypic Detection of Carbapenem-Resistant Gram-Negative Bacilli from a Clinical Specimen in Sidama, Ethiopia: A Cross-Sectional Study

Alemayehu

Asnake

Tadesse

et al. 2021

IDR

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Background Carbapenem-resistant gram-negative bacteria are an emergent source of both community-acquired and healthcare-associated infection that poses a substantial hazard to public health. This study aimed to conclude the magnitude of carbapenem resistance gram-negative bacteria from a clinical specimen at Hawassa University Comprehensive Specialized Hospital. Methods A hospital-based cross-sectional study was accompanied from February 13 to June 7, 2020, in which consecutive patients with 103 gram-negative bacteria were encompassed. The isolates included were 54 urine, 17 blood, 17 pusses, 4 cerebrospinal fluid (CSF), 3 aspirates, 3 effusions, 2 stools, 2 ear discharges, and 1 nasal swab. A semi-structured questionnaire was used to gather socio-demographic data from the attendant and clinical data from the patient’s chart. Patients admitted in any wards and visited outpatients department were included for the study if gram-negative bacteria was identified for those who accepted the consent. A routine manual culture, Gram’s staining and biochemical tests used to identify the bacteria. Antibiotic susceptibility was determined for twelve antibiotics including cotrimoxazole, ceftazidime, meropenem, gentamycin, chloramphenicol, ampicillin, ciprofloxacin, cefotaxime, cefuroxime, nitrofurantoin, piperacillin-tazobactam, and amikacin using the Kirby-Bauer disc diffusion method. Modified carbapenem inactivation (mCIM) method was used to determine carbapenem resistance using meropenem disk as per the recommendation of Clinical and Laboratory Standards Institute guideline. Statistical package for social science software version 21 was used for data entry and analysis. The odds ratio at 95% confidence interval (CI) and p-value <0.05 were taken as a statistically significant association. Results Generally, 111 gram-negative bacteria were identified from 103 patients. Of 111 isolates, thirteen isolates (nine resistance and four intermediates) were identified in disk diffusion testing for meropenem. Of this, 10 isolates were carbapenemases producer with the overall rates of 9% in the Modified carbapenem inactivation method (mCIM). Pseudomonas spp. 3 (30.0%), E. coli, K. pneumonia, Acinetobacter spp. each two (20.0%), and K. oxytoca 1 (10.0%) were identified as carbapenemases positive. The rates of the multidrug, extensive, pan drug were 86.5, 43.3, and 1.8, respectively. Ampicillin 94 (97.9%), followed by cefuroxime 52 (91.2%), cefotaxime 94 (88.7%), cotrimoxazole 58 (88.1%), ceftazidime 40 (83.3%), ciprofloxacin 47 (77.1%), nitrofurantoin 35 (70.0%), gentamycin 71 (65.7%), with high level of resistance. However, piperacillin-tazobactam 41 (48.8%), chloramphenicol 25 (47.2%), meropenem 13 (11.7%), and amikacin 9 (8.5%) were with low rates of resistance. In this study, there were no variables statically associated with carbapenem resistance that is p > 0.05. ...

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Section: Discussionmentioning

confidence: 99%

Phenotypic Detection of Carbapenem-Resistant Gram-Negative Bacilli from a Clinical Specimen in Sidama, Ethiopia: A Cross-Sectional Study

Alemayehu

Asnake

Tadesse

et al. 2021

IDR

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“…Reduced susceptibility to carbapenems are also increasingly reported even though for now, resistance among bacterial infections to carbapenems has not attained any crisis level but their presence is considered an emerging threat to health care (Eshetie et al, 2015). There are reports of increasing incidence of resistance to carbapenems in core clinical settings in Nigeria [31,32]. The bacteria also demonstrated diversity in their ability to resist multiple antibiotics of different groups.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Resistance Patterns among Gram-negative Bacteria from Patients with Urinary Tract Infection at a Healthcare Center in Ekiti-State, Nigeria

Ajayi¹,

Osanyinlusi²,

Ogeneh³

et al. 2019

AJMR

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Urinary Tract Infections (UTIs) are huge health burden. This study determined the current incidence of antibiotic resistance among Gram-negative bacteria from patients with UTI at a health center in Ado Ekiti, Nigeria. One hundred and twenty two mid-stream urine samples were collected and cultured. Sixty-four samples (52.4%) grew significant bacteria. Gram-negative bacterial colonies were picked per plate, identified and tested for susceptibility to the following antibiotics: Ertapenem (10µg), meropenem (10µg), ceftazidime (30µg), ceftriaxone (30µg), gentamicin (10µg), ampicillin (10µg), tetracycline (30µg), norfloxacin (10µg) and pefloxacin (5µg). Thirty-nine isolates were selected for extended spectrum beta-lactamase production using the double disk synergy test. All the bacteria were tested for biofilms and haemolysis. Sixty-four Gram-negative bacterial isolates were recovered from 64 samples. The bacteria recovered included K. pneumonia, K. oxytoca, P. vulgaris, E. coli, P. mirabilis and P. aeruginosa. Overall, the bacteria showed the highest resistance to ampicillin 60/64 (94.5%) and least resistance to meropenem 18/64 (28.1%). All the bacteria tested for ESBL production were confirmed as ESBL producers. Twenty-two (34.3%) isolates were strong biofilm producers while 19 isolates were haemolytic (29.7%). These findings have serious implications to medical care and public health. Strict antibiotic stewardship should be enforced.

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“…9,10 Gram-negative organisms are responsible for most clinical infections; therefore the emergence of carbapenem resistance among them is of public health significance. 11 Also, there is limited treatment option as approved drugs used against them (colistin and tigecycline) are fraught with high toxicities 12 and they can be easily disseminated. 13…”

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confidence: 99%

Prevalence of Phenotypic Carbapenem-Resistant Enterobacterales Isolates and Their Distribution by Sex, Age Groups, State and Species in South-East Nigeria

Ugah

Udeani

2022

GJMS

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Background: Carbapenems are broad spectrum β-lactam antibiotics that were introduced in response to the emergence of ESBL-producing Gram-negative bacteria. This study aimed at determining the occurence of carbapenem resistant Enterobacterales isolates among patients attending five tertiary hospitals with southeastern region of Nigeria. Methods: A total of 400 Enterobacterales were isolated from different participants. Carbapenem-resistance was detected using Kirby-Bauer disc diffusion method with ertapenem, meropenem, imipenem, and doripenem. Results: A total of 117 isolates (29.2%) were resistant to the four carbapenems. When compared among the states, the prevalence were 33.6%, 29.1%, 28.8%, 26.9% and 24.7% for Enugu, Ebonyi, Imo, Anambra and Abia states respectively. The highest resistance was observed among P. mirabilis (52.6%) followed by K. oxytoca (35.7%), S. enterica (35.7%) and K. pneumoniae (33.8%). Conclusion: The overall prevalence was high and this is a cause for concern and urgent need for emergency intervention to forestall widespread emergence of pandrug resistant infections.

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Carbapenemase-producing Gram-negative bacteria: An emerging threat to health care in Africa

Cited by 6 publications

References 13 publications

Phenotypic Detection of Carbapenem-Resistant Gram-Negative Bacilli from a Clinical Specimen in Sidama, Ethiopia: A Cross-Sectional Study

Phenotypic Detection of Carbapenem-Resistant Gram-Negative Bacilli from a Clinical Specimen in Sidama, Ethiopia: A Cross-Sectional Study

Antibiotic Resistance Patterns among Gram-negative Bacteria from Patients with Urinary Tract Infection at a Healthcare Center in Ekiti-State, Nigeria

Prevalence of Phenotypic Carbapenem-Resistant Enterobacterales Isolates and Their Distribution by Sex, Age Groups, State and Species in South-East Nigeria

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