High Prevalence of Multi-Drug Resistance and Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae Among Hospitalized Patients Presumptive for Bacterial Infection at Debre Berhan Comprehensive Specialized Hospital, Ethiopia

Sahle, Zenawork; Engidaye, Getabalew; Shenkute, Demissew; Metaferia, Yeshi; Shibabaw, Agumas

doi:10.2147/idr.s363988

Cited by 3 publications

(4 citation statements)

References 37 publications

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“…Article from 6 regions (Amhara, SNNPR, Sidama, Harari, Tigray, Somali) and one federal city Addis Ababa) met the criteria. A total of 40 articles that were published from 2018-2022 identified for the study, including 19 articles from Amhara region [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38], 7 articles from Addis Ababa [39][40][41][42][43][44][45], 5 articles from SNNPR [46][47][48][49][50], 3 articles from Sidama [51][52][53], 3 articles from Harari [54][55][56], 2 articles from Tigray [57,58]…”

Section: Search Resultsmentioning

confidence: 99%

“…Concerning articles based on specimen type, most of the articles (21 articles) reported MDR Klebsiella from urine [21-23, 25, 27, 30, 33, 38-41, 43, 44, 48-50, 53, 56, 58, 59]. It is followed by seven (7) articles from blood [20,35,37,42,46,47,51], 4 articles from sputum [24,34,52,57], 3 articles from eye swabs [26,28,45], 2 articles from body fluid [31,55], 1 article for each of this specimen stool [32]: vaginal discharge [36] and ear discharge [29]. All the susceptibility testing was conducted with the disk diffusion method.…”

Section: Plos Onementioning

confidence: 99%

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Prevalence of phenotypic multi-drug resistant Klebsiella species recovered from different human specimens in Ethiopia: A systematic review and meta-analysis

Kijineh,

Alemeyhu,

Mengistu

et al. 2024

PLoS ONE

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Background Multidrug-resistant (MDR) Klebsiella species are among public health important bacteria that cause infections difficult to treat with available antimicrobial agents. Infections with Klebsiella lead to high morbidity and mortality in developing countries particularly in patients admitted to the intensive care unit. This systematic review and meta-analysis aimed to determine the pooled prevalence of MDR Klebsiella species from different human specimens using studies conducted in Ethiopia from 2018−2022. Methods We have systematically searched online databases such as PubMed/Medline, Google Scholar, Hinari, African journals online, Web of Science, Cochrane, and grey literature (Addis Ababa University and Hawassa University) to identify studies reporting the proportion of MDR Klebsiella species in Ethiopia. Published articles were selected based on the Preferred Reporting Item of Systematic Review and Meta-analysis (PRISMA). R-Studio version 4.2.3 was used to conduct pooled prevalence, heterogeneity test, and publication bias. A binary random effect model was used to determine the pooled prevalence. Heterogeneity was checked with the inconsistency index (I2). Publication bias was checked with a funnel plot and Egger test. Sensitivity analysis was conducted with leave-one-out analysis. Joanna Briggs Institute’s critical appraisal tool for prevalence studies was used to check the quality of each article. Results In this systematic review and meta-analysis, 40 articles were included in which 12,239 human specimens were examined. Out of the total specimens examined, 721 Klebsiella species were isolated and 545 isolates were reported to be MDR Klebsiella species. The prevalence of MDR Klebsiella species ranged from 7.3%-100% whereas the pooled prevalence of MDR Klebsiella species was 72% (95% CI: 63 − 82%, I2 = 95%). Sub-group analysis based on region revealed the highest prevalence of MDR from Addis Ababa (97%) and the least from the Somali region (33%); whereas sub-group analysis based on the specimen type indicated the highest prevalence was from blood culture specimens 96% and the least was from other specimens (ear and vaginal discharge, and stool) (51%). Conclusion Our finding indicated a high prevalence of MDR Klebsiella species found in different human specimens. The prevalence of MDR Klebsiella varies across regions in Ethiopia, age, the type of specimens, source and site of infection. Therefore, integrated action should be taken to reduce the prevalence of MDR Klebsiella species in regional states and focus on clinical features. Effective infection and prevention control should be applied to reduce the transmission within and outside health care settings.

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Section: Search Resultsmentioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

Prevalence of phenotypic multi-drug resistant Klebsiella species recovered from different human specimens in Ethiopia: A systematic review and meta-analysis

Kijineh,

Alemeyhu,

Mengistu

et al. 2024

PLoS ONE

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“…According to various reports, antimicrobial resistance (AMR) poses a serious threat to public health everywhere, 12 including in Ethiopia with different AMR reports among humans and animal products 11,13,14 . Human can contract resistant bacteria from a variety of sources such as food products, the environment, and food handlers.…”

Section: Introductionmentioning

confidence: 99%

“…11 According to various reports, antimicrobial resistance (AMR) poses a serious threat to public health everywhere, 12 including in Ethiopia with different AMR reports among humans and animal products. 11,13,14 Human can contract resistant bacteria from a variety of sources such as food products, the environment, and food handlers. A significant issue in developing countries is the emergence and spread of antibiotic-resistant bacteria, which can be easily contracted as a result of substandard living conditions and limited access to medical care.…”

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confidence: 99%

Bacterial foodborne illness and Escherichia coli O157:H7 strain infection among asymptomatic food handlers in Northeast Ethiopia: Implication for hygienic practices and mass‐screening

Adefrash,

Sharew,

Amare

et al. 2024

Health Science Reports

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Background and AimsFood‐borne illness is a public health concern in developing countries because of improper food handling and sanitation practices, irregular medical checkups, lack of clean water supplies, and inadequate education among food handlers. This study investigated the burden of bacterial food‐borne illness, antibiotic resistance patterns, and associated factors among food handlers in prison and nonprison food establishment settings.MethodsA cross‐sectional study was conducted from August 2022 to January 2023 among asymptomatic food handlers in Shewa Robit town. A total of 384 food handlers participated. Data were collected using structured questionnaires. Stool and hand swab samples were collected and cultivated onto MacConkey agar, xylose‐lysine‐deoxycholate, Mannitol salt agar, and blood agar, and incubated at 37°C. Bacterial species were identified using biochemical tests and gram staining. Mueller–Hinton agar was used in Kirby Bauer's disk diffusion method. Data were entered and analyzed using SPSS. Descriptive and logistic regression analysis were performed.ResultsFecal and hand carriage rate of bacterial isolates were 106 (27.6%), and 214 (55.7%), respectively. Out of the 102 bacterial isolates, the most common ones from stool samples were Escherichia coli 71 (18.5%), Klebsiella aerogenes 12 (3.1%), and Salmonella spp. 7 (1.8%). Among 214 bacterial isolates, coagulase‐negative Staphylococci 115 (29.9%) and Staphylococci aureus 66 (17.3%) were identified from hand swab samples. Hand washing practice after restroom with water (adjusted odds ratio [AOR] = 2; 95% confidence interval [CI]: 1.16–3.45), irregular medical checkups (AOR = 2.49; 95% CI: 1.35–4.59), and did not receive food safety and hygiene training (AOR = 2.33; 95% CI: 1.34–4.05) were statistically significant association with food‐borne illness.ConclusionsFoodborne pathogens pose a serious health risk in the study areas. The level of antimicrobial resistance are also concerning. Food handlers should therefore get strict regular health education, medical checkups, and training programs to prevent the spread of infections to the customers.

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Evaluation of three protocols for direct susceptibility testing for gram negative-Enterobacteriaceae from patient samples in Uganda with SMS reporting

Aruhomukama,

Magiidu,

Katende

et al. 2024

Sci Rep

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In Uganda, the challenge of generating and timely reporting essential antimicrobial resistance (AMR) data has led to overreliance on empirical antibiotic therapy, exacerbating the AMR crisis. To address this issue, this study aimed to adapt a one-step AMR testing protocol alongside an SMS (Short Message Service) result relay system (SRRS), with the potential to reduce the turnaround time for AMR testing and result communication from 4 days or more to 1 day in Ugandan clinical microbiology laboratories. Out of the 377 samples examined, 54 isolates were obtained. Notably, E. coli (61%) and K. pneumoniae (33%) were the most frequently identified, majority testing positive for ESBL. Evaluation of three AMR testing protocols revealed varying sensitivity and specificity, with Protocol A (ChromID ESBL-based) demonstrating high sensitivity (100%) but no calculable specificity, Protocol B (ceftazidime-based) showing high sensitivity (100%) and relatively low specificity (7.1%), and Protocol C (cefotaxime-based) exhibiting high sensitivity (97.8%) but no calculable specificity. ESBL positivity strongly correlated with resistance to specific antibiotics, including cefotaxime, ampicillin, and aztreonam (100%), cefuroxime (96%), ceftriaxone (93%), and trimethoprim sulfamethoxazole (87%). The potential of integrating an SRRS underscored the crucial role this could have in enabling efficient healthcare communication in AMR management. This study underscores the substantial potential of the tested protocols for accurately detecting ESBL production in clinical samples, potentially, providing a critical foundation for predicting and reporting AMR patterns. Although considerations related to specificity warrant careful assessment before widespread clinical adoption.

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High Prevalence of Multi-Drug Resistance and Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae Among Hospitalized Patients Presumptive for Bacterial Infection at Debre Berhan Comprehensive Specialized Hospital, Ethiopia

Cited by 3 publications

References 37 publications

Prevalence of phenotypic multi-drug resistant Klebsiella species recovered from different human specimens in Ethiopia: A systematic review and meta-analysis

Prevalence of phenotypic multi-drug resistant Klebsiella species recovered from different human specimens in Ethiopia: A systematic review and meta-analysis

Bacterial foodborne illness and Escherichia coli O157:H7 strain infection among asymptomatic food handlers in Northeast Ethiopia: Implication for hygienic practices and mass‐screening

Evaluation of three protocols for direct susceptibility testing for gram negative-Enterobacteriaceae from patient samples in Uganda with SMS reporting

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