Meta-analysis of proportion estimates of Extended-Spectrum-Beta-Lactamase-producing Enterobacteriaceae in East Africa hospitals

Sonda, Tolbert; Kumburu, Happiness; Zwetselaar, Marco van; Alifrangis, Michael; Lund, Ole; Kibiki, Gibson; Aarestrup, Frank Møller

doi:10.1186/s13756-016-0117-4

Cited by 83 publications

(93 citation statements)

References 62 publications

(70 reference statements)

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“…In this review E. coli and K. pneumoniae were predominant ESBL‐PE; an observation previously reported within and outside the African continent (Lautenbach, Patel, Bilker, Edelstein, & Fishman, ; Sonda et al., ; Storberg, ). The worldwide pandemic clone E. coli ST131 (Nicolas‐Chanoine et al., , ) predominated in this review (Moremi et al., ; Mshana et al., ; Mshana, Imirzalioglu, et al., ; Seni et al., ).…”

Section: Discussionsupporting

confidence: 58%

“…In this review, the overall ESBL‐PE prevalence pooled from the three interfaces was found to be 22.6%, which is within the range of ESBL prevalence in other African countries such as Kenya, Algeria and Cameroon irrespective of the categories (Kiiru, Kariuki, Goddeeris, & Butaye, ; Storberg, ). However, this overall prevalence is lower compared to 42% reported among humans in East African hospitals (Sonda et al., ). Prevalence in the later may be accounted by the fact that these ESBL bacterial isolates were from patients in the hospitals where MDR bacteria prevail.…”

Section: Discussionmentioning

confidence: 67%

“…The ESBL‐PE burden among humans and animals has been widely described in Tanzania (Lupindu et al., ; Madoshi et al., ; Sonda et al., ), as opposed to their occurrence in the environmental sources (Lyimo, Buza, Subbiah, Smith, & Call, ). There is high faecal carriage of ESBL strains among children and in the general population, which in turn may partly explain their involvement in fatal sepsis among vulnerable children population in this country (Blomberg et al., ; Kayange, Kamugisha, Mwizamholya, Jeremiah, & Mshana, ; Mhada, Fredrick, Matee, & Massawe, ).…”

Section: Introductionmentioning

confidence: 99%

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Preliminary insights into the occurrence of similar clones of extended‐spectrum beta‐lactamase‐producing bacteria in humans, animals and the environment in Tanzania: A systematic review and meta‐analysis between 2005 and 2016

Seni

Moremi

Matee

et al. 2017

Zoonoses and Public Health

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The emergence and spread of extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) are complex and of the public health concern across the globe. This review aimed at assessing the ESBL-PE clones circulating in humans, animals and the environment to provide evidence-based insights for combating ESBL-PE using One Health approach. Systematic search from Medline/PubMed, Google Scholar and African Journals Online was carried out and retrieved nine eligible articles (of 131) based on phenotypic and genotypic detection of ESBL-PE between 2005 and 2016 in Tanzania. Analysis was performed using STATA 11.0 software to delineate the prevalence of ESBL-PE, phenotypic resistance profiles and clones circulating in the three interfaces. The overall prevalence of ESBL-PE in the three interfaces was 22.6% (95% CI: 21.1-24.2) with the predominance of Escherichia coli (E. coli) strains (51.6%). The majority of ESBL-PE were resistant to the commonly used antimicrobials such as trimethoprim-sulfamethoxazole and tetracycline/doxycycline, 38%-55% were resistant to ciprofloxacin and all were sensitive to meropenem/imipenem. ESBL-PE infections were more associated with deaths compared to non-ESBL-PE infections. Strikingly, E. coli ST38, ST131 and ST2852 were found to intersect variably across the three interfaces. The predominant allele, bla was found mostly in the conjugative IncF plasmids connoting transmission potential. The high prevalence of ESBL-PE and shared clones across the three interfaces, including the global E. coli ST131 clone, indicates wide and inter-compartmental spread that calls for One Health genomic-driven studies to track the resistome flow.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

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Preliminary insights into the occurrence of similar clones of extended‐spectrum beta‐lactamase‐producing bacteria in humans, animals and the environment in Tanzania: A systematic review and meta‐analysis between 2005 and 2016

Seni

Moremi

Matee

et al. 2017

Zoonoses and Public Health

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“…On the other hand, carbapenemases are carbapenem-hydrolyzing beta-lactamases that confer resistance to a broad spectrum of beta-lactam substrates, including carbapenems. Recent studies performed in the region of East Africa show a wide variation in ESBLs prevalence in hospitals between the different countries with a pooled proportion of 40% reported in a meta-analysis (23). Carbapenemases have been documented in several countries in Africa and Rendani et al in their systematic review have suggested that the problem might be bigger than what is currently estimated due to underreporting (11).…”

Section: Introductionmentioning

confidence: 98%

Molecular characterization of multidrug-resistant Klebsiella pneumoniae and Escherichia coli harbouring extended spectrum beta-lactamases and carbapenemases genes at a tertiary hospital, Kenya

Maina¹,

Govind²,

Whitelaw³

2017

Microbiol Med

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SummaryBackground. Multidrug-resistant (MDR) Gram negative rods are increasingly being reported in sub-Saharan Africa. Molecular investigations play an important role, alongside other measures, in controlling nosocomial infections attributed to these organisms.This study aimed to determine the common extended spectrum beta-lactamases (ESBL) and carbapenemases genes, and clonal relationship in MDR Klebsiella pneumoniae and Escherichia coli.Methods. Fifty-four MDR isolates collected at the Aga Khan University hospital, Nairobi in the month of August 2012 formed the study. These were picked after an increase in the number of resistant strains during the said period was experienced.Results. blaCTXM was present in 41 (74%) of the isolates, while blaSHV was detected in 18 (33%) and blaTEM in 13 (24%) of the isolates.Nine (16.7%) of the isolates harboured all three ESBL genes and 8 (14.8%) harboured two. Eight of the isolates (all E. coli) had none of the ESBL genes tested. Two isolates harboured carbapenemases genotypes: one had blaNDM-1 and the other blaSPM.Sequencing matched CTXM-15 and TEM-1 genes in all the isolates harbouring blaCTXM and blaTEM respectively. However, there was diversity in blaSHV with SHV-11 and SHV-12 genes predominant. The isolates were non-clonal.Conclusions. The isolates mostly harboured blaCTX-M-15 while only a few had carbapenemases genes. Lack of clonality suggests these were the stable circulating strains at the time of the study.

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“…Several studies in East Africa have also documented high rates of ESBL-PE from clinical settings (8,9).…”

Section: Introductionmentioning

confidence: 99%

High fecal carriage of Extended Beta Lactamase producing Enterobacteriaceae among adult patients admitted in Referral Hospitals in Dar es salaam, Tanzania

Kibwana

Majigo

Kamori

et al. 2019

Preprint

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Background Multi-drug resistance pathogens such as Extended-Spectrum Beta-Lactamase (ESBL) producing Enterobacteriaceae (ESBL-PE) are of great global health concern, since they are associated with increased morbidity and mortality. Even in the absence of infections caused by these pathogens, colonization is a great threat and can lead to cross transfer among hospitalized patients. To date data on carriage of these pathogens is still limited in Tanzania. Therefore, this study aimed to determine ESBL-PE fecal carriage rate and associated factors among hospitalized patients at Referral hospitals in Dar es Salaam. Methods This was a cross sectional study conducted from May to July 2017 among patients admitted in three referral hospitals in Dar es Salaam, Tanzania. Rectal swabs were collected and screened for ESBL production using MacConkey agar supplemented with Ceftazidime 1mg/L. Phenotypic confirmation of ESBL-PE was done by double disk diffusion method. Statistical analysis was performed using Statistical Package for Social Sciences (SPPS) software version 20. Results Of the 196 enrolled participants, 59.7% (117/196) were confirmed to carry ESBL-PE. A total of 131 ESBL-PE were isolated from 117 patients, whereby, Escherichia coli accounted for 68.7%, Klebsiella pneumoniae 28.2% and Citrobacter species 0.8%. ESBL-PE carriage was significantly higher in patients with diarrhea compared to those without diarrhea (72% vs 53.1%, p=0.01). Recent antibiotic use was independently associated with carriage of ESBL-PE (aOR 14.65, 95%CI 3.07-69.88, p=0.01).Conclusions High fecal carriage of ESBL-PE was observed in patients admitted in tertiary hospitals in Dar es Salaam, Tanzania. The use of antibiotics was associated with carriage of ESBL producers among the study population.

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Meta-analysis of proportion estimates of Extended-Spectrum-Beta-Lactamase-producing Enterobacteriaceae in East Africa hospitals

Cited by 83 publications

References 62 publications

Preliminary insights into the occurrence of similar clones of extended‐spectrum beta‐lactamase‐producing bacteria in humans, animals and the environment in Tanzania: A systematic review and meta‐analysis between 2005 and 2016

Preliminary insights into the occurrence of similar clones of extended‐spectrum beta‐lactamase‐producing bacteria in humans, animals and the environment in Tanzania: A systematic review and meta‐analysis between 2005 and 2016

Molecular characterization of multidrug-resistant Klebsiella pneumoniae and Escherichia coli harbouring extended spectrum beta-lactamases and carbapenemases genes at a tertiary hospital, Kenya

High fecal carriage of Extended Beta Lactamase producing Enterobacteriaceae among adult patients admitted in Referral Hospitals in Dar es salaam, Tanzania

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