Emergence of high drug resistant bacterial isolates from patients with health care associated infections at Jimma University medical center: a cross sectional study

Gashaw, Mulatu; Berhane, Melkamu; Bekele, Shiferaw; Kibru, Gebre; Teshager, Lule; Yilma, Yonas; Ahmed, Yesuf; Fentahun, Netsanet; Assefa, Henok; Wieser, Andreas; Gudina, Esayas Kebede; Ali, Solomon

doi:10.1186/s13756-018-0431-0

Cited by 82 publications

(92 citation statements)

References 31 publications

(35 reference statements)

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“…However, the current result was higher than of the study findings reported from Jima Ethiopia (51%) [17] and of study conducted in Algeria (47.6%) [18] and lower than reported from a tertiary care hospital in Riyadh capital Saudi Arabia (72%) [19]. These indicate that the distribution of ESBL producing organisms vary from region to region and may be higher in certain geographic areas [20].…”

Section: Bacterial Strainscontrasting

confidence: 85%

Antimicrobial Susceptibility Profile of Extended Spectrum Beta- lactamases Producing Enterobacteriaceae isolated from clinical samples refereed to the National Bacteriology and Mycology Reference Laboratory, Ethiopia

Aseffa

Tigabu

Shiferaw

et al. 2020

Preprint

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Background Extended-spectrum beta-lactamases (ESBL) producing Enterobacteriaceae are prevalent worldwide and they are unique challenges for treatment and control of bacterial infectious diseases. ESBL genes not only confer resistance to oximino-cephalosporins and aztreonum but also, they are multidrug-resistant to other commonly available antimicrobial agents used in clinical practice.Objective To determine the prevalence and antimicrobial susceptibility profile of ESBL producing Enterobacteriaceae isolated from clinical samples referred to the national clinical bacteriology and mycology reference laboratory.Materials and Methods A cross-sectional study was conducted on Enterobacteriaceae culture- positive clinical samples that were referred to the national bacteriology and mycology reference laboratory from August 2018 to July 2019. Bacterial isolation was performed according to the inoculation and incubation conditions of each clinical specimen and identifications of the isolates were performed using standardized biochemical tests for gram-negative bacteria. Antimicrobial susceptibility profiles of these cultures were determined using the disk diffusion method on Muller Hinton agar according to the recommendation by Clinical and Laboratory Standard Institute (CLSI). ESBL production was detected using CLSI Screening and confirmation test. A double-disk synergy test was used for confirmation.Results Out of 371 culture positive for Enterobacteriaceae , 240 (64.7%) were positive for ESBL production, and the most prevalent species were Klebsiella sp 131(54.6%) followed by E. coli 79 (32.9%). Of 131 ESBL positive Klebsiella spp, 95 (72.5%) were obtained from blood samples and among 79 E. coli isolates, 51 (64.6%) of the strains were isolated from urine samples. All ESBL positive isolates were resistant to ampicillin and all generation of cephalosporins. In addition, 100% of them were multidrug resistant. There were also high proportions of resistant ESBL positive isolates to other classes of antimicrobial agents. Less resistance rates were documented for carbapenems drugs and amikacin from the class of aminoglycosides.Conclusion ESBL producing Enterobacteriaceae we reported in this study was not only highly prevalent but also they are multidrug resistant to most clinically available antimicrobial agents including carbapenems. Therefore, public awareness and regular monitoring

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Section: Bacterial Strainscontrasting

confidence: 85%

Antimicrobial Susceptibility Profile of Extended Spectrum Beta- lactamases Producing Enterobacteriaceae isolated from clinical samples refereed to the National Bacteriology and Mycology Reference Laboratory, Ethiopia

Aseffa

Tigabu

Shiferaw

et al. 2020

Preprint

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“…Six studies were found in Addis Ababa [ 19 – 21 , 23 , 25 , 31 ], five studies in Amhara region [ 8 , 16 , 26 , 27 , 29 ], five studies in Oromia [ 9 , 17 , 18 , 28 , 30 ], one study both in Addis Ababa and Southern Nation Nationalities and People Region (SNNPR) [ 22 ], one each in Tigray [ 24 ] and SNNPR [ 10 ]. Nine studies were conducted across all age groups.…”

Section: Resultsmentioning

confidence: 99%

Healthcare-associated infection and its determinants in Ethiopia: A systematic review and meta-analysis

et al. 2020

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Background Healthcare-associated infection is a global threat in healthcare which increases the emergence of multiple drug-resistant microbial infections. Hence, continuous surveillance data is required before or after patient discharge from health institutions though such data is scarce in developing countries. Similarly, ongoing infection surveillance data are not available in Ethiopia. However, various primary studies conducted in the country showed different magnitude and determinants of healthcare-associated infection from 1983 to 2017. Therefore, this systematic review and meta-analysis aimed to estimate the national pooled prevalence and determinants of healthcare-associated infection in Ethiopia. Methods We searched PubMed, Science Direct, Google Scholar, and grey literature deposited at Addis Ababa University online repository. The quality of studies was checked using Joanna Brigg’s Institute quality assessment scale. Then, the funnel plot and Egger’s regression test were used to assess publication bias. The pooled prevalence of healthcare-associated infection was estimated using a weighted-inverse random-effects model meta-analysis. Finally, the subgroup analysis was done to resolve the cause of statistical heterogeneity. Results A total of 19 studies that satisfy the quality assessment criteria were considered in the final meta-analysis. The pooled prevalence of healthcare-associated infection in Ethiopia as estimated from 18 studies was 16.96% (95% CI: 14.10%-19.82%). In the subgroup analysis, the highest prevalence of healthcare-associated infection was in the intensive care unit 25.8% (95% CI: 3.55%-40.06%) followed by pediatrics ward 24.16% (95% CI: 12.76%-35.57%), surgical ward 23.78% (95% CI: 18.87%-29.69%) and obstetrics ward 22.25% (95% CI: 19.71%-24.80%). The pooled effect of two or more studies in this meta-analysis also showed that patients who had surgical procedures (AOR = 3.37; 95% CI: 1.85–4.89) and underlying non-communicable disease (AOR = 2.81; 95% CI: 1.39–4.22) were at increased risk of healthcare-associated infection. Conclusions The nationwide prevalence of healthcare-associated infection has remained a problem of public health importance in Ethiopia. The highest prevalence was observed in intensive care units followed by the pediatric ward, surgical ward and obstetrics ward. Thus, policymakers and program officers should give due emphasis on healthcare-associated infection preventive strategies at all levels. Essentially, the existing infection prevention and control practices in Ethiopia should be strengthened with special emphasis for patients admitted to intensive care units. Moreover, patients who had surgical procedures and underlying non-communicable diseases should be given more due attention.

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“…β-lactam resistance is an increasing problem for the infection treatment, thereby, use of carbapenem antibiotics for treatment of infections caused by EEBL producing microorganisms was implemented. Nevertheless, carbapenem resistant strains have been reported, elevating patients’ mortality index (15).…”

Section: Discussionmentioning

confidence: 99%

“…Resistance is associated with the expression of genes contained in plasmids, transposons and integrones which are key elements in horizontal genetic material transference. Klebsiella carbapenem resistance has been principally associated with plasmids (15, 17).…”

Section: Discussionmentioning

confidence: 99%

First report of New Clonal groups ST706 and ST1088 from MDR Klebsiella pneumoniae Mexican strains

Córdova-Espinoza

Arana

Giono-Cerezo

et al. 2019

Preprint

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Multidrug-resistant Klebsiella pneumoniae Mexican strains were characterized for the identification of endemic and pandemic clonal groups. The aims of this study were to know population structure and to identify endemic clonal groups inside K. pneumoniae Mexican strains isolated from clinical sources. We studied 93 isolated strains from three third level hospitals and one family clinic from Mexico City. Identification of the strains was done by conventional microbiological methods and an automated system (Vitek2®). The multidrug-resistant phenotype was confirmed following CLSI recommendations, and the strains were classified as MDR, XDR and PDR. Molecular characterization was done by Multilocus Sequence Typing scheme (rpoB, gapA, mdh, pgi, phoE, infB, y tonB). All strains were isolated from hospitalized patients, the most frequent sources were urine and blood cultures. Population structure of K. pneumoniae was clonal, 30 ST were identified, six of them are commonly found. The Clonal complex ST25, ST36, S5392, ST405 and ST551 were isolated from clinical sources, ST1088 was isolated from surfaces of hospital environment.

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Emergence of high drug resistant bacterial isolates from patients with health care associated infections at Jimma University medical center: a cross sectional study

Cited by 82 publications

References 31 publications

Antimicrobial Susceptibility Profile of Extended Spectrum Beta- lactamases Producing Enterobacteriaceae isolated from clinical samples refereed to the National Bacteriology and Mycology Reference Laboratory, Ethiopia

Antimicrobial Susceptibility Profile of Extended Spectrum Beta- lactamases Producing Enterobacteriaceae isolated from clinical samples refereed to the National Bacteriology and Mycology Reference Laboratory, Ethiopia

Healthcare-associated infection and its determinants in Ethiopia: A systematic review and meta-analysis

First report of New Clonal groups ST706 and ST1088 from MDR Klebsiella pneumoniae Mexican strains

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