Extended-spectrum beta-lactamase production and multi-drug resistance among Enterobacteriaceae isolated in Addis Ababa, Ethiopia

Teklu, Dejenie Shiferaw; Negeri, Abebe Aseffa; Legese, Melese Hailu; Bedada, Tesfaye Legesse; Woldemariam, Hiwot Ketema; Tullu, Kassu Desta

doi:10.1186/s13756-019-0488-4

Cited by 163 publications

(212 citation statements)

References 45 publications

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“…E. coli, the most common isolate was sensitive to gentamycin and imipenem. This is similar to what has been found in other studies [3,14,28] in which the gram negative isolates are resistant to commonly used antibiotics.…”

Section: Plos Onesupporting

confidence: 92%

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Asymptomatic bacteriuria among pregnant women attending antenatal care at Mbale Hospital, Eastern Uganda

et al. 2020

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BackgroundAsymptomatic bacteriuria in pregnancy (ASBP) is associated with adverse pregnancy outcomes such as pyelonephritis, preterm or low birth weight delivery if untreated. The aim of this study was to determine the prevalence of asymptomatic bacteriuria, the isolated bacterial agents, and their antibiotic sensitivity patterns in pregnant women attending antenatal care at Mbale Hospital. MethodsThis was a cross sectional study in which 587 pregnant women with no symptoms and signs of urinary tract infection were recruited from January to March 2019. Mid-stream clean catch urine samples were collected from the women using sterile containers. The urine samples were cultured using standard laboratory methods. The bacterial colonies were identified and antibiotic sensitivity was done using disc diffusion method. Chi squared tests and logistic regression were done to identify factors associated with asymptomatic bacteriuria. A p value < 0.05 was considered statistically significant. ResultsOut of the 587 pregnant women, 22 (3.75%) tested positive for asymptomatic bacteriuria. Women aged 20-24 years were less likely to have ASBP when compared to women aged less than 20 years (AOR = 0.14, 95%CI 0.02-0.95, P = 0.004). The most common isolates in descending order were E. coli (n = 13, 46.4%) and S.aureus (n = 9, 32.1%). Among the gram negative isolates, the highest sensitivity was to gentamycin (82.4%) and imipenem (82.4%). The gram positive isolates were sensitive to gentamycin (90.9%) followed by imipenem (81.8%). All the isolates were resistant to sulphamethoxazole with trimethoprim PLOS ONE PLOS ONE | https://doi.

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Section: Plos Onesupporting

confidence: 92%

“…resistance to β lactam antibiotics is due to production of Extended Spectrum β Lactamase production by the gram negative isolates, acquisition of resistance genes, down regulation of receptors and drug efflux [28,33,35]. This is mainly due to selective pressure generated by the use of the third generation cephalosporins [36].…”

Section: Plos Onementioning

confidence: 99%

Asymptomatic bacteriuria among pregnant women attending antenatal care at Mbale Hospital, Eastern Uganda

et al. 2020

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“…In the current study, the predominant ESBLs producing GNB was K. pneumoniae (56.1%) than E. coli (43.8%). This finding was supported by previous studies done in Addis Ababa, K. pneumoniae (78.6%) and E. coli (52.2%) [36], Bahir Dar: K. pneumoniae (69.8%) and E. coli (58.2%) [28], North West Nigeria: K. pneumoniae (62.9%) and E. coli (54.2%) [37], Southwestern Uganda: K. pneumoniae (52%) and E. coli (44%) [38], Nairobi: K. pneumoniae (78.8%) and E. coli (60.7%) [42], Uganda: K. pneumoniae (72.7 %) and E. coli (58.1% [43]. On the other side, our finding was in contrary to study conducted in Sri Lanka: E. coli (86.8%) and K. pneumoniae (13.1%) [44], India: E. coli (50.14%) and K. pneumoniae (48.3%) [45] in which E. coli was the predominant ESBLs producer than K. pneumoniae.…”

Section: Magnitude Of Esbls Producing Gram Negative Bacillisupporting

confidence: 90%

“…However, the magnitude of ESBLs production among GNB in our study was lower than studies done in Addis Ababa 57.7% [36], Bahir Dar 57.6% [28], North West Nigeria 58.0% [37], Southwestern Uganda 89% [38] and Southeast Iran 53.8% [23]. This wide variation might be due to differences in study population, type of specimen, sample size, the extent of antibiotic use and mainly the methodology used.…”

Section: Magnitude Of Esbls Producing Gram Negative Bacillicontrasting

confidence: 62%

Extended-spectrum Beta-lactamase and AmpC Beta-lactamase producing gram negative bacilli isolated from clinical specimens at International Clinical Laboratories, Addis Ababa, Ethiopia

Tekele¹,

Teklu

Legese

et al. 2019

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Background : For Gram negative pathogens, production of beta-lactamase (β-lactamases) enzymes are the main mechanisms of resistance for most antimicrobial drugs. Of these β-lactamases, Extended spectrum Beta-lactamases (ESBL) and AmpC β-lactamases (AmpC) are the commonest enzymes produced by gram negative bacilli which are main mechanisms for the resistance all generations of cephalosporins. This study was therefore, aimed to assess the magnitude of ESBL and AmpC producing gram negative bacilli (GNB) isolated from clinical specimens at International clinical Laboratories, Addis Ababa, Ethiopia. Methods: A cross sectional study was conducted between January to May 2018. From different clinical specimens, 338 GNB were isolated. Bacterial species identification, antimicrobial susceptibility testing and β-lactamases screening were performed using phoenix automated system (BD phoenix 100 ). Cefoxitin resistant bacteria were confirmed for AmpC β-lactamases production by AmpC confirmatory disc. ESBLs production was confirmed using a combination disc method. Data were analyzed using SPSS version 20 software. Results: The predominant GNB was E. coli 66.0% (224/338) followed by K. pneumoniae 12.1% (41/338). The overall magnitude of ESBL producing GNB was 38.8% (131/338) while AmpC β-lactamases producing GNB was 2.4% (8/338). The majority of ESBLs and AmpC β-lactamases producing GNB were isolated from urine specimen 47.5% (116/338). Ampicillin (75.4%), amoxicillin with clavulanic acid (64.0%) and sulfamethoxazole-trimethoprim (55.6%) were most common resistance antibiotics. Multidrug resistance (MDR) level was 73.7% (249/338). Of ESBLs and AmpC β-lactamases producing GNB, 99.3% were MDR (P < 0.05). Conclusion: The magnitude of ESBL and AmpC β-lactamases producing GNB were significantly high which is worrying that needs intervention to minimize further occurrence and spread of such GNB. The MDR level was high which suggests continuous monitoring & reviewing of antimicrobial policy in hospitals and the country at large. Keywords: Extended spectrum β-lactamase, AmpC β-lactamase, Multidrug Resistance, Gram negative bacilli, Addis Ababa, Ethiopia

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“…This finding is comparable to that was reported in Addis Ababa (57.7%) [14], in Pakistan (60%) [15] and reported from Nigeria (65%) [16].…”

Section: Bacterial Strainssupporting

confidence: 89%

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

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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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Extended-spectrum beta-lactamase production and multi-drug resistance among Enterobacteriaceae isolated in Addis Ababa, Ethiopia

Cited by 163 publications

References 45 publications

Asymptomatic bacteriuria among pregnant women attending antenatal care at Mbale Hospital, Eastern Uganda

Asymptomatic bacteriuria among pregnant women attending antenatal care at Mbale Hospital, Eastern Uganda

Extended-spectrum Beta-lactamase and AmpC Beta-lactamase producing gram negative bacilli isolated from clinical specimens at International Clinical Laboratories, Addis Ababa, 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

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