Prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae isolated from blood cultures in Africa

Sangare, Samba Adama; Guindo, Ibréhima; Maiga, Aminata; Camara, Namory; Savadogo, S.; Diallo, Souleymane; Bougoudogo, F; Armand-Lefèvre, Laurence; Andremont, Antoine; Maïga, Ibrahim

doi:10.1016/j.medmal.2015.08.003

Cited by 32 publications

(32 citation statements)

References 57 publications

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“…Fecal carriage of ESBL producing organisms in hospitalized patients has shown large variations worldwide [8–12, 22, 23]. The overall fecal carriage rates of ESBL-producing Enterobacteriaceae in our study from Ethiopia’s largest referral hospital (52%) is comparable to the overall pooled ESBL proportion estimate for East African hospitals (42%) [11], Cameron (55.3%)[24] and Ghana (49.3%) [25], but it is much higher than reports from Europe (5.4–25%) and the United States (1–25%) [22, 23].…”

Section: Discussionmentioning

confidence: 99%

“…However, data on the colonization rate with ESBL producing isolates, particularly on antibacterial resistance from developing countries particularly from sub Saharan Africa is yet limited mainly due to resource constrains [1, 7]. Available reports indicate that ESBL-producing Enterobacteriaceae in hospital and community settings in Africa is common, and the reported colonization rates as well as the resistance pattern vary between different countries with in the continent [8–12]. Considering the limited diagnostic and treatment possibilities in resource-poor countries, reliable surveillance data on antibacterial resistance in different African countries including Ethiopia is urgently required to raise awareness, map the burden and the resistance pattern for effective intervention measures, treatment recommendations and to identify emerging threats.…”

Section: Introductionmentioning

confidence: 99%

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High Gastrointestinal Colonization Rate with Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Hospitalized Patients: Emergence of Carbapenemase-Producing K. pneumoniae in Ethiopia

et al. 2016

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We investigated the gastrointestinal colonization rate and antibiotic resistance patterns of Extended-Spectrum Beta-Lactamase (ESBL)- producing Escherichia coli and Klebsiella pneumoniae in hospitalized patients admitted at Ethiopia’s largest tertiary hospital. Fecal samples/swabs from 267 patients were cultured on chrome agar. ESBL. Bacterial species identification, verification of ESBL production and antibiotic susceptibility testing were done using Vitek 2 system (bioMérieux, France). Phenotype characterization of ESBL-E.coli and ESBL- K.pneumoniae was done using Neo-Sensitabs™. ESBL positivity rate was much higher in K. pneumoniae (76%) than E. coli (45%). The overall gastrointestinal colonization rate of ESBL producing Enterobacteriaceae (ESBL-E) in hospitalized patients was 52% (95%CI; 46%–58%) of which, ESBL-E. coli and K.pneumoniae accounted for 68% and 32% respectively. Fecal ESBL-E carriage rate in neonates, children and adults was 74%, 59% and 46% respectively. Gastrointestinal colonization rate of ESBL-E.coli in neonates, children and adults was 11%, 42% and 42% respectively. Of all E. coli strains isolated from adults, children and neonates, 44%, 49% and 22% were ESBL positive (p = 0.28). The prevalence of ESBL-K.pneumoniae carriage in neonates, children and adults was 68%, 22% and 7% respectively. All K. pneumoniae isolated from neonates (100%) and 88% of K. pneumoniae isolated from children were ESBL positive, but only 50% of K.pneumoniae isolated from adults were ESBL positive (p = 0.001). Thirteen patients (5%) were carriers of both ESBL-E.coli and ESBL-KP. The overall carrier rate of ESBL producing isolates resistant to carbapenem was 2% (5/267), all detected in children; three with E.coli HL cephalosporinase (AmpC), resistant to ertapenem and two with K. pneumoniae Carbapenemase (KPC) resistant to meropenem, ertapenem and impenem. We report a high gastrointestinal colonization rate with ESBL-E and the emergence of carbapenems-resistant K. pneumoniae in Ethiopia. Urgent implementation of infection control measures, and surveillance are urgently needed to limit the spread within healthcare facilities and further to the community.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High Gastrointestinal Colonization Rate with Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Hospitalized Patients: Emergence of Carbapenemase-Producing K. pneumoniae in Ethiopia

et al. 2016

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“…There are also some reviews about the general situation in the whole continent, but most of them are concentrated in human clinical and community settings (Storberg ; Sangare et al . ; Sekyere et al . ).…”

Section: Introductionmentioning

confidence: 99%

“…Despite limited resources, the incidence of AMR Enterobacteriaceae in Africa, and more specifically, ESBL producers has also been studied at the local level in different countries. There are also some reviews about the general situation in the whole continent, but most of them are concentrated in human clinical and community settings (Storberg 2014;Sangare et al 2015;Sekyere et al 2016). In the present review, we aim to describe the situation of AMR E. coli in FPA and foods of animal origin in Africa, with particular focus on ESBL/pAmpC-producing isolates.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic resistance in Escherichia coli in husbandry animals: the African perspective

Alonso

Zarazaga

Sallem

et al. 2017

Letters in Applied Microbiology

134

106

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In the last few years, different surveillances have been published in Africa, especially in northern countries, regarding antimicrobial resistance among husbandry animals. Information is still scarce, but the available data show a worrying picture. Although the highest resistance rates have been described against tetracycline, penicillins and sulphonamides, prevalence of plasmidmediated quinolone resistance genes and extended spectrum b-lactamase (ESBL) are being increasingly reported. Among ESBLs, the CTX-M-1 group was dominant in most African surveys. Within this group, CTX-M-15 was the main variant both in animals and humans, except in Tunisia where CTX-M-1 was more frequently detected among Escherichia coli from poultry. Certain bla CTX-M-15 -harbouring clones (ST131/B2 or ST405/D) are mainly identified in humans, but they have also been reported in livestock species from Tanzania, Nigeria or Tunisia. Moreover, several reports suggest an inter-host circulation of specific plasmids (e.g. bla CTX-M-1 -carrying IncI1/ST3 in Tunisia, IncY-and Incuntypeable replicons co-harbouring qnrS1 and bla CTX-M-15 in Tanzania and the worldwide distributed bla CTX-M-15 -carrying IncF-type plasmids). International trade of poultry meat seems to have contributed to the spread of other ESBL variants, such as CTX-M-14, and clones. Furthermore, first descriptions of OXA-48-and OXA-181-producing E. coli have been recently documented in cattle from Egypt, and the emergent plasmid-mediated colistin resistance mcr-1 gene has been also identified in chickens from Algeria, Tunisia and South Africa. These data reflect the urgent need of a larger regulation in the use of veterinary drugs and the implementation of surveillance programmes in order to decelerate the advance of antimicrobial resistance in this continent.

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“…(IQR:[18][19][20][21][22][23][24][25][26][27][28][29][30] years. Half of the study participants were aged between 18 and 27 years, and those above 57 years were the least (0.5%).…”

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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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Prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae isolated from blood cultures in Africa

Cited by 32 publications

References 57 publications

High Gastrointestinal Colonization Rate with Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Hospitalized Patients: Emergence of Carbapenemase-Producing K. pneumoniae in Ethiopia

High Gastrointestinal Colonization Rate with Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Hospitalized Patients: Emergence of Carbapenemase-Producing K. pneumoniae in Ethiopia

Antibiotic resistance in Escherichia coli in husbandry animals: the African perspective

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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