Molecular characterization and distribution of cephalosporin resistance determinants in Escherichia coli and Klebsiella pneumoniae isolated from patients attending Kampala International University Teaching Hospital in Bushenyi, Western Uganda

Abstract

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Phenotypic And Genotypic Characterization of Extended Spectrum Beta- Lactamase-Producing Clinical Isolates of Escherichia coli and Klebsiella pneumoniae in Two Kenyan Facilities: A National Referral and a Level Five Hospital

“…Besides, our ndings indicated a high proportion of K. pneumoniae isolates were ESBL producers, which corroborates earlier reports from Kenya [53], [54], Uganda [35], [36], [55], Tanzania [33], Ethiopia [34], and Nepal [40], [41]. Notably, previous reports from Kenya [31], [56], Tanzania [46], Uganda [45], Ethiopia [57], Nigeria [37], Burkina Faso[38], Chad [39], Iran [50], Nepal [51], Thailand [48], Brazil [49], and the USA [58] showed that the proportion of ESBL-producing K. pneumoniae isolates was lower than that which we report herein. These differences may be due to disparities in infection prevention control protocols, local antimicrobial treatment guidelines, abuse of broadspectrum antibiotics and third generation cephalosporins, geographical dynamics, hospitalisation, and the presence and effectiveness of antimicrobial stewardship committees at various health facilities in various territories [59].…”

“…Additionally, surveys conducted in other countries, including Rwanda [32], Tanzania [33], Ethiopia [34], Uganda [35], [36], Nigeria [37], Burkina Faso [38], Chad [39], and Nepal [40]; [41] revealed a similar pattern of ESBL production in E. coli isolates. However, the proportion of ESBL-producing E. coli isolates in this study was lower than that reported in Kenya [42], [43], Uganda [44], [45], Tanzania [46], Canada [47], Thailand [48], Brazil [49], Iran [50], Nepal [51], the USA, Europe, Asia-Paci c, and Latin America [52]. Besides, our ndings indicated a high proportion of K. pneumoniae isolates were ESBL producers, which corroborates earlier reports from Kenya [53], [54], Uganda [35], [36], [55], Tanzania [33], Ethiopia [34], and Nepal [40], [41].…”

“…mediated β-lactamase, which hydrolyses and inactivates β-lactam antibiotics, including monobactams and cephalosporins, among a wide array of other antibiotics, rendering them useless[5],[79],[80].Molecular studies have revealed various ESBL variants in E. coli and K. pneumoniae based on the gene or gene combinations they express [81]-[83]. Upon genotypic characterisation, the bla TEM gene was the most profoundly expressed in E. coli, and K. pneumoniae isolates, followed by bla SHV , bla OXA, and bla CTX−M−group−1 depicting a similar pattern as that reported in Uganda[45], Iran[50], Kenya[54] , [84], and Tanzania[85]. However, our results differ from those reported in Burkina Faso[38], Chad…”

Phenotypic and Genotypic Characterization of Extended Spectrum Beta-Lactamase-Producing Clinical Isolates of Escherichia coli and Klebsiella pneumoniae in Two Kenyan Facilities: A National Referral and a Level Five Hospital

“…Besides, our findings indicated a high proportion of K. pneumoniae isolates were ESBL producers, which corroborates earlier reports from Kenya [ 56 , 57 ], Uganda [ 41 , 42 , 58 ], Tanzania [ 4 ], Ethiopia [ 40 ], and Nepal [ 46 , 47 ]. Notably, previous reports from Kenya [ 38 , 59 ], Tanzania [ 5 ], Uganda [ 51 ], Ethiopia [ 60 ], Nigeria [ 43 ], Burkina Faso [ 44 ], Chad [ 45 ], Iran [ 14 ], Nepal [ 54 ], Thailand [ 53 ], Brazil [ 18 ], and the USA [ 61 ] showed that the proportion of ESBL-producing K. pneumoniae isolates was lower than that which we report herein. These differences may be due to disparities in infection prevention control protocols, local antimicrobial treatment guidelines, abuse of broad-spectrum antibiotics and third generation cephalosporins, geographical dynamics, hospitalisation, and the presence and effectiveness of antimicrobial stewardship committees at various health facilities in various territories [ 62 ].…”

Phenotypic Characterization and Antibiograms of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli Isolated at the Human-Animal-Environment Interface Using a One Health Approach Among Households in Wakiso District, Uganda

“… 6 , 7 E. coli has been implicated in both nosocomial and community-acquired infections, including respiratory tract infections, urinary tract infections, and enteric infections in Uganda and beyond. 8 , 9 E. coli’s threat is mainly attributed to its ability to rapidly acquire antibiotic resistance through multiple mechanisms. 10 Whereas evidence globally indicates the presence of E. coli in the environment and animals.…”