Extended-Spectrum Beta-Lactamase- and Carbapenemase-Producing Enterobacteriaceae Family of Bacteria from Diarrheal Stool Samples in Northwest Ethiopia

Abstract

Background. Resistance among the commensal flora is a serious threat because they are highly populated ecosystems like the gut, maybe a source of extraintestinal infections. Infections due to extended-spectrum beta-lactamase (ESBL)- and carbapenemase (CPM)-producing Enterobacteriaceae family of bacteria impose a major global issue because they are usually resistant to multiple antimicrobial agents. Data on the fecal ESBL- and CPM-producing group of bacteria in developing countries including Ethiopia are limited mainly due to resource constraints. Thus, this study aimed to determine the prevalence of multidrug-resistant (MDR)-, ESBL-, and CPM-producing Enterobacteriaceae family of bacteria from diarrheal stool samples at the University Hospital, Northwest Ethiopia. Materials and Methods. A hospital-based cross-sectional study was conducted involving a total of 384 study participants having gastrointestinal complaints from January to April 2019. A diarrheal stool sample was aseptically collected and inoculated on a MacConkey agar plate. After getting pure colonies, biochemical and antimicrobial susceptibility testing was done following standard microbiological techniques. ESBL production was screened using ceftazidime and cefotaxime and confirmed using a combined disk diffusion test. Carbapenemases were screened by meropenem disk and confirmed by the modified carbapenem inactivation method. Data were checked, cleaned, and entered using Epi Info version 7.1 and transferred to SPSS version 20 for analysis. Result. A total of 404 Enterobacteriaceae groups of bacteria were isolated from 384 diarrheal stool samples. The overall prevalence of fecal MDR-, ESBL-, and CPM-producing group of Enterobacteriaceae was 196 (48.5%), 66 (16.3%), and 4 (1%), respectively. Of the total ESBL-producing Enterobacteriaceae, E. coli (41/66 (62.1%)) and K. pneumoniae (18/66 (27.3%)) were the most predominant isolates. One half of CPE has been observed in Citrobacter species and the rest in E. coli (25%) and P. vulgaris (25%). Conclusion and Recommendation. Finding the high rate of ESBL-producing Enterobacteriaceae and CPE requires strict infection control measures and careful selection of empirical therapy in the study area. Therefore, active surveillance with large sample size and better infection prevention control is needed.

Enterobacteriaceae (Order Enterobacterales), <i>Pseudomonas aeruginosa</i> and <i>Acinetobacter spp</i> Carbapenemase producers isolated from patients hospitalized in ICU during the COVID-19 pandemic, 2020.

“…El incremento de la resistencia bacteriana se debe a la presencia de unas enzimas denominadas ßlactamasas, las cuales inhiben el mecanismo de acción de los antibióticos ß-lactámicos mediante el proceso de hidrolisis del antibiótico (León-Luna et al, 2021;Chicaiza-Tayupanta y Chicaiza-Quishpe, 2021). Dentro de los ß-lactámicos, se pueden mencionar a los carbapenémicos, los cuales presentan un amplio espectro de actividad antibacteriana contra microorganismos grampositivos y gramnegativos (Rada et al, 2019), y debido a que son los más eficaces, estos son considerados dentro de los medicamentos en la última línea y más confiable de los fármacos para tratar las infecciones bacterianas, además de ser más seguros que otros fármacos similares pues presentan pocas consecuencias adversas en las personas (Worku et al, 2022).…”

Fecal Carriage of Carbapenem Resistant Enterobacterales and Associated Factors Among Admitted Patients in Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

“…However, there are very few reported data on CPE. 13 , 14 Therefore, this study is designed to determine the prevalence of carbapenem-resistant Enterobacterales , determine the prevalence of carbapenemase-producing Enterobacterales , and associated factors among admitted patients.…”

Carbapenemase-Producing Bacteria Isolated from ICU Patients of a Peruvian Government Hospital during the COVID-19 Pandemic: A Descriptive Analysis

“…These antibiotics are considered to be among the last-line drugs and the most reliable for treating bacterial infections. They are also safer than other similar drugs because they have few adverse side-effects [15]. Carbapenems interrupt bacterial cell wall formation as a result of covalent binding to the essential penicillin-binding proteins 1a, 1b, and 3 (PBP1a, 1b, and 3), which induces spheroplast formation and cell lysis without filament formation [16,17].…”