Molecular characterisation of extended-spectrum β-lactamase-producing Gram-negative bacterial isolates from surgical wounds of patients at a hospital in North Central Nigeria

Olowo-Okere, Ahmed; Ibrahim, Y. K. E.; Olayinka, Busayo Olalekan

doi:10.1016/j.jgar.2018.02.002

Cited by 24 publications

(17 citation statements)

References 17 publications

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“…In the present study, β -lactamase-producing bacteria were commonly found in ICU and surgical departments. This finding is similar to that reported in the eastern region of Saudi Arabia [20] and many parts of the world, such as in Algeria [21] and Nigeria [22]. It has been suggested that the higher use of invasive devices and the selective pressure of newer β -lactams for patients at ICU and surgery unit result in the emergence of such pathogens [20].…”

Section: Discussionsupporting

confidence: 86%

“…However, our result was lower than 72% reported at a tertiary care hospital in Riyadh capital [1]. High prevalence of ESBL-producing bacteria has been observed in many African and Asian countries, such as 47.6% in Algeria [21], 60% in Pakistan [8], and 65% in Nigeria [22]. By contrast, the lowest proportions of ESBL-producing Enterobacteriaceae have been reported in Europe, such as below 1% in Sweden [23] and 5% in Netherlands [24].…”

Section: Discussioncontrasting

confidence: 66%

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Phenotypic Characterization and Antibiotic Resistance Patterns of Extended-Spectrum β-Lactamase- and AmpC β-Lactamase-Producing Gram-Negative Bacteria in a Referral Hospital, Saudi Arabia

Ibrahim

Abbas

Al-Shahrai

et al. 2019

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background. Emergence of pathogenic bacteria carrying β-lactamase-resistant determinants has become a major health problem in the hospital setting. The study aimed to determine antibiotic-resistant patterns and frequency of extended-spectrum β-lactamase- (ESBL-) producing Gram-negative bacteria (GNB) and AmpC β-lactamase-producing GNB. Methodology. A prospective cross-sectional study was conducted during a period from September 2017 to August 2018 at King Abdullah Hospital, Bisha Province, Saudi Arabia. GNB (n = 311) were recovered from patients’ clinical specimens including sputum, urine, wound pus, blood, tracheal aspirates and high vaginal swabs, umbilical discharge, eye discharge, and cerebrospinal fluids. Isolates were identified by the Phoenix identification system. Antimicrobial susceptibility was tested by the Kirby–Bauer disk procedure. Phenotypic characterization of ESBLs and AmpC β-lactamases was performed utilizing the double-disk synergy test and inhibitor-based method, respectively. Associations with outcome measures were determined by simple descriptive statistics and a chi-square test. Results. Out of 311 GNB isolates, the frequency of ESBL and AmpC β-lactamase producers was 84 (27%) and 101 (32.5%), respectively. Klebsiella pneumoniae and Escherichia coli were common ESBL producers. AmpC β-lactamases predominate among Acinetobacter spp. and Pseudomonas aeruginosa. Coproduction of ESBLs and AmpC β-lactamases was found in 36 (11.6%) isolates, with very close relative frequencies among K. pneumoniae, Acinetobacter spp., and P. aeruginosa. β-Lactamase producers were predominantly found in the surgical department (56.5%) and ICUs (44.2%). ESBL producers revealed high resistance for cefuroxime (96.4%), cefotaxime (92.9%), and trimethoprim/sulfamethoxazole (90.5%). The resistance rates were significantly higher among ESBL producers than nonproducers for cephalosporins (p<0.001), amoxicillin/clavulanate (p<0.001), piperacillin/tazobactam (p=0.010), nitrofurantoin (p=0.027), aztreonam (p<0.001), ciprofloxacin (p=0.002), and trimethoprim/sulfamethoxazole (p<0.001). Significantly higher (p<0.05) resistance rates were observed among AmpC β-lactamase producers than nonproducers for all tested antibiotics. Conclusions. This finding showed a high prevalence of ESBL- and AmpC β-lactamase-producing GNB in our hospital. Quality control practice and routine detection of β-lactamase producers before deciding on antibiotic therapy are advocated.

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Section: Discussionsupporting

confidence: 86%

Section: Discussioncontrasting

confidence: 66%

Phenotypic Characterization and Antibiotic Resistance Patterns of Extended-Spectrum β-Lactamase- and AmpC β-Lactamase-Producing Gram-Negative Bacteria in a Referral Hospital, Saudi Arabia

Ibrahim

Abbas

Al-Shahrai

et al. 2019

Canadian Journal of Infectious Diseases and Medical Microbiolog

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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: 88%

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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“…However, immune system of most hospitalized patients is compromised from malnutrition during hospitalization, disease condition such as HIV/AIDS or drugs such as cytotoxic and steroids [ 9 ]. In addition, harbouring of resistant genes with possibility of horizontal transfer of these resistant genes coupled with intrinsic antimicrobial resistance in some bacteria may explain why some of the bacteria survived competent host immune response and antibiotics to cause clinical infections [ 34 , 35 ]. According to Owens and Stoessel (2008), antibiotic-resistant pathogens such as methicillin-resistant Staphylococcus aureus , vancomycin-resistant enterococci, and extended spectrum beta-lactamase-producing Enterobacteriaceae are responsible for significant number of SSI [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Occurrence of Surgical Site Infections at a Tertiary Healthcare Facility in Abuja, Nigeria: A Prospective Observational Study

et al. 2018

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Surgical site infection (SSI) is one of the most frequent complications of surgical interventions. Several factors have been identified as major determinants of occurrence of SSIs. The present study determined the occurrence and possible risk factors associated with SSIs at a tertiary healthcare facility in Abuja, Nigeria. All patients scheduled for operation in the hospital during the study period and who consented to participate willingly in the study were observed prospectively for the occurrence of SSI based on criteria stipulated by the United States Centre for Disease Control and Prevention (CDC). Data on sociodemographic characteristics, lifestyle, surgical procedure and co-morbidity were collected into a pre-tested data collection tool and analysed using IBM SPSS Statistics software v.24. Predictors of SSIs were identified using multivariate logistic regression model and p-value less than 0.05 was considered statistically significant. Of the 127 surgical patients that met the inclusion criteria comprising 65 (51.2%) females and 62 (48.8%) males between 1 and 83 years with mean age of 25.64 ± 1.66 years, 35 (27.56%; 95% Confidence Interval (CI): 0.205–0.360) developed SSIs. Prolonged post-operative hospital stays (p < 0.05), class of wound (p < 0.0001) and some comorbid conditions were found to be significantly associated with higher SSI rate. The SSI rate was highest among patients that had Kirschner-wire insertion (75.0%), followed by an unexpectedly high infection rate among patients that had mastectomy (42.9%), while lower percentages (33.3%) were recorded among patients that had exploratory laparotomy and appendicectomy. The overall magnitude of SSIs in this facility is high (27.6%; 95% CI: 0.205–0.360). Several factors were found to be independent predictors of occurrence of SSI. The findings thus highlight the need for improved surveillance of SSIs and review of infection control policies of the hospital.

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Molecular characterisation of extended-spectrum β-lactamase-producing Gram-negative bacterial isolates from surgical wounds of patients at a hospital in North Central Nigeria

Cited by 24 publications

References 17 publications

Phenotypic Characterization and Antibiotic Resistance Patterns of Extended-Spectrum β-Lactamase- and AmpC β-Lactamase-Producing Gram-Negative Bacteria in a Referral Hospital, Saudi Arabia

Phenotypic Characterization and Antibiotic Resistance Patterns of Extended-Spectrum β-Lactamase- and AmpC β-Lactamase-Producing Gram-Negative Bacteria in a Referral Hospital, Saudi Arabia

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

Occurrence of Surgical Site Infections at a Tertiary Healthcare Facility in Abuja, Nigeria: A Prospective Observational Study

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