scholarly journals Multi-drug resistant, extended spectrum beta-lactamase and carbapenemase producing bacterial isolates among children under five years old with suspected bloodstream infection in a specialized hospital in Ethiopia: Cross-sectional study

2019 ◽  
Author(s):  
Mequanint Mitiku Tadesse ◽  
Zeleke Ayenew Matebie ◽  
Kassu Desta Tullu
Keyword(s):  
Pediatric Patients ◽  
Bacterial Pathogens ◽  
Febrile Illness ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Extended Spectrum Beta Lactamase ◽  
Under Five ◽  
Extended Spectrum ◽  
Specialized Hospital ◽  
Tikur Anbessa Specialized Hospital

Abstract BackgroundBloodstream infections due to bacterial pathogens are a major cause of morbidity and mortality among pediatric patients. Emergence of drug resistance in high classes to antibiotics among the bacterial pathogens is another issue of public health concern. Therefore, this study was conducted to determine multi-drug resistant, extended spectrum β-lactamase and carbapenemase producing bacterial isolates among suspected bloodsteam infection patients in children under five years of age at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.MethodsA cross-sectional study was conducted from September 2017 to June 2018 among pediatric patients with febrile illness under five years of age at Tikur Anbessa Specialized Hospital. Three hundred and forty blood samples were collected and processed following standard microbiological techniques and blood culture was performed using a BacT/Alert instrument in combination with conventional methods for identification. Antimicrobial susceptibility testing of the isolates was performed using the Kirby-Bauer disc diffusion method to determine the minimum inhibitory concentration (MIC).ResultA total of 137 (40.2%) bacterial pathogens were isolated from 340 pediatric patients suspected of bloodstream infection with febrile illness. Of these isolates, 54% were Gram negative bacteria. Among gram negative isolates 43 (31.4%) were identified as Klebsiella pneumoniae and 8.7% Acinetobacter species were the most frequently isolated pathogens. Klebsiella pneumoniae isolates were 88.4 % (38/43) MDR, 32.5% (14/43) ESBL, and 37.2 %( 16/43) CRE .ConclusionIn this study, highly resistant Klebsiella pneumoniae are common pathogen associated with BSI. Extended spectrum beta-lactamase (ESBL) producing strains were common in Klebsiella species and Escherichia coli isolates. Since most of isolates exhibit multidrug resistance, in vitro antimicrobial susceptibility testing is mandatory. A strengthened antimicrobial surveillance system and antimicrobial stewardship programs are necessary for better selection of antibiotics in addition to improved infection prevention practices in hospital settings.

scholarly journals Multi-drug resistant, extended spectrum beta-lactamase and carbapenemase-producing bacterial isolates among children under five years old suspected bloodstream infection in a specialized Hospital in Ethiopia: Cross-sectional study

2019 ◽  
Author(s):  
Mequanint Mitiku Tadesse ◽  
Zeleke Ayenew Matebie ◽  
Kassu Desta Tullu
Keyword(s):  
Pediatric Patients ◽  
Bacterial Pathogens ◽  
Febrile Illness ◽  
Beta Lactamase ◽  
Drug Resistant ◽  
Extended Spectrum Beta Lactamase ◽  
Under Five ◽  
Extended Spectrum ◽  
Specialized Hospital ◽  
Tikur Anbesa Specialized Hospital

Abstract Background : Bloodstream infections due to bacterial pathogens are a major cause of morbidity and mortality among pediatric patients. Emergence of drug resistance in high classes of antibiotics among the bacterial pathogens is another issue of the public health concern. Therefore, this study aimed to determine Multi-drug resistant, extended spectrum β-lactamase and carbapenemase producing bacterial isolates among septicemia suspected under five Children in Tikur Anbesa Specialized Hospital, Addis Ababa Ethiopia. Methods : Across-sectional study was conducted from September 2017 to June 2018 among pediatric patients with febrile illness aged under five in Tikur Anbesa Specialized Hospital. Three hundred forty blood samples were collected and processed following standard microbiological techniques and culture was performed using BacT/Alert machine in combination with conventional method. Antimicrobial susceptibility testing of the isolates was performed by Kirby-Bauer disc diffusion method and MIC technique. Result: A total of 137(40.2%) bacterial pathogens were isolated from 340 pediatric patients suspected of BSI with febrile illness. Of these isolates 54% were Gram negative bacteria. Among gram negative isolates 43 (31.4%) Klebsiella pneumonia e and Acinitiobacter species were the most frequently isolated pathogens. Klebsiella pneumoniae isolates were 95.6% MDR, 23.7% ESBL, and 27.1% CRE in children. Conclusion : In this study, Klebsiella pneumoniae is a common pathogens associated with BSI in pediatrics with high antimicrobial resistance. Extended spectrum beta-lactamase producing organisms were common in Klebsiella species and Escherichia coli isolates. Since most of isolates exhibit multidrug resistant, invitro- susceptibility of antimicrobials is mandatory. Strengthen antimicrobial surveillance system and antimicrobial stewardship is necessary for better management of antibiotics in addition to infection prevention practice in Hospital settings.

scholarly journals Multi-Drug Resistant, Extended Spectrum beta-Lactamase and Carbapenemase Producing Bacterial Isolates among Septicemia Suspected under Five Children in Tikur Anbesa Specialized Hospital, Addis Ababa Ethiopia: Cross-sectional study

2019 ◽  
Author(s):  
Mequanint Mitiku ◽  
Zeleke Ayenew ◽  
Kassu Desta
Keyword(s):  
Klebsiella Pneumoniae ◽  
Pediatric Patients ◽  
Addis Ababa ◽  
Bacterial Pathogens ◽  
Bacterial Isolates ◽  
Extended Spectrum Beta Lactamase ◽  
Under Five ◽  
Extended Spectrum ◽  
Specialized Hospital ◽  
Tikur Anbesa Specialized Hospital

Abstract Background: Bloodstream infections due to bacterial pathogens are a major cause of morbidity and mortality among pediatric patients. Emergence of drug resistance in high classes of antibiotics among the bacterial pathogens is another issue of the public health concern. Therefore this study aimed to determine Multi-drug resistant, extended spectrum β-lactamase and carbapenemase producing bacterial isolates among septicemia suspected under five Children in Tikur Anbesa Specialized Hospital, Addis Ababa Ethiopia. Methods: Across-sectional study was conducted from September 2017 to June 2018 among pediatric patients with febrile illness aged under five in Tikur Anbesa Specialized Hospital. Three hundred forty blood samples were collected and processed following standard microbiological techniques and culture was performed using BacT/Alert machine in combination with conventional method. AST of the isolates was performed by Kirby-Bauer disc diffusion method and MIC technique Result: A total of 137(40.2%) bacterial pathogens were isolated from 340 pediatric patients suspected of BSI with febrile illness. Of these isolates 54% were Gram negative bacteria. Of the isolates 43 (31.4%) Klebsiella pneumoniae and Acinitiobactor species were the most frequently isolated pathogens. Klebsiella pneumoniae isolates were 95.6% MDR, 23.7% ESBL, and 27.1% CRE in children. Conclusion: In this study, Klebsiella pneumoniae and S. aureus are common pathogens associated with BSI in pediatrics with high antimicrobial resistance. The prevalence of MDR 51.1%, CRE 30.5% and ESBL 25.4% were alarmingly high in bacterial isolates. ESBL producing organisms were common in Klebsiella species and Escherichia coli isolates. Since most of isolates exhibit multidrug resistant, invitro- susceptibility of antimicrobials is mandatory. Strengthen antimicrobial surveillance system and antimicrobial stewardship are necessary for better management of antibiotics in addition to infection prevention practice in TASH settings. Key words: Blood stream infection, BacT/Alert, multi-drug resistance, Extended spectrum beta-lactamase, Carbapenem resistance entrobacteriaciae.

scholarly journals Multi-Drug Resistant, Extended Spectrum β-Lactamase and Carbapenemase Producing Bacterial Isolates among Septicemia Suspected under Five Children in Tikur Anbesa Specialized Hospital, Addis Ababa Ethiopia

2019 ◽  
Author(s):  
Mequanint Mitiku ◽  
Zeleke Ayenew ◽  
Mequanint Mitiku
Keyword(s):  
Klebsiella Pneumoniae ◽  
Pediatric Patients ◽  
Addis Ababa ◽  
Bacterial Pathogens ◽  
Febrile Illness ◽  
Drug Resistant ◽  
Bacterial Isolates ◽  
Under Five ◽  
Specialized Hospital ◽  
Tikur Anbesa Specialized Hospital

Abstract Background: Bloodstream infections due to bacterial pathogens are a major cause of morbidity and mortality among pediatric patients. Emergence of drug resistance in high classes of antibiotics among the bacterial pathogens is another issue of the public health concern. Objective: To determine Multi-drug resistant, extended spectrum β-lactamase and carbapenemase producing bacterial isolates among septicemia suspected under five Children in Tikur Anbesa Specialized Hospital, Addis Ababa Ethiopia. Methods: Across-sectional study was conducted from September 2017 to June 2018 among pediatric patients with febrile illness aged under five in Tikur Anbesa Specialized Hospital. 340 Blood samples were collected and processed following standard microbiological techniques and culture was performed using BacT/Alert machine in combination with conventional method. AST of the isolates was performed by Kirby-Bauer disc diffusion method and MIC technique Result: A total of 137(40.2%) bacterial pathogens were isolated from 340 pediatric patients suspected of BSI with febrile illness. Of these isolates 54% were Gram negative bacteria. Of the isolates 43 (31.4%) Klebsiella pneumonia Acinitobactor species were the most frequently isolated pathogens. Klebsiella pneumoniae isolates were 95.6% MDR, 23.7% ESBL, and 27.1% CRE in children.Conclusion: In this study, Klebsiella pneumoniae and S. aureus are common pathogens associated with BSI in pediatrics with high antimicrobial resistance. The prevalence of MDR 51.1%, CRE 30.5% and ESBL 25.4% were alarmingly high in bacterial isolates. ESBL producing organisms were common in Klebsiella species and Escherichia coli isolates. Since most of isolates exhibit multidrug resistant, invitro- susceptibility of antimicrobials is mandatory. Strengthing antimicrobial surveillance system and antimicrobial stewardship are necessary for better management of antibiotics in addition to infection prevention practice in TASH settings.

scholarly journals Justification and Optimization Principles of ALARA in Pediatric CT at a Teaching Hospital in Ethiopia

2020 ◽  
Vol 30 (5) ◽  
Author(s):  
Daniel Z. Solomon ◽  
Bezawit Ayalew ◽  
Seife T. Dellie ◽  
Daniel Admasie
Keyword(s):  
Pediatric Patients ◽  
Background Radiation ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Specialized Hospital ◽  
Tikur Anbessa Specialized Hospital ◽  
Radiation Induced ◽  
Unnecessary Radiation ◽  
Cancer Studies

BACKGROUND: Radiation from CT (computerized tomography), poses risk of radiation associated cancer. Studies indicate a cumulative dose of 50mGy triples the risk of leukemia and a dose of 60mGy triples the risk of brain tumors in children. This study aimed to assess the application of “Justification and Optimization Principles of ALARA (As Low As Reasonably Achievable)” in pediatric CT.METHOD: A prospective cross-sectional study was conducted from December 2017 to July 2018 G.C at Tikur Anbessa Specialized Hospital. CT request forms were reviewed. All pediatric patients listed for CT were included. The collected data were analyzed using SPSS version 25.RESULTS: Four hundred and twenty nine CT requests were reviewed, 246 (57.3%) were males and 183(42.7%) were females; 52(12.1%) were less than 1 year old, 153(35.7%) between 1 to 5 years, 113(26.3%) between 5 to 10 years and 111(25.8%) 10 to 14 years old. On the other hand, 28(6.5%) scan requests were rejected based on the ALARA justification principle, and from these, in 11(39.2%) MRI was recommended instead of CT, in 6(21.42%) US was recommended. Review of previous CT helped to reject 4(14.28%). Review of prior chest radiographs helped in rejecting 2(7.14%) requests. For 5(17.8%) and 19(4.4%), requests were optimized by applying principles of optimization to reduce received dose from CT.CONCLUSION: Overall, 47(11%) patients were protected from unnecessary radiation exposure by applying the principles of ALARA. The use of other alternating imaging modalities is vital in pediatric patients who are more radiosensitive and have longer time to manifest radiation induced injury.

scholarly journals Prevalence and Factors Associated with Undernutrition on Cancer Patients at Tikur Anbessa Specialized Hospital, Ethiopia: A cross-sectional study

2021 ◽  
Author(s):  
Eyerusalem Worku ◽  
Hayat Aragaw ◽  
Damitie Kebede
Keyword(s):  
Cancer Patients ◽  
Addis Ababa ◽  
Performance Status ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Under Nutrition ◽  
Specialized Hospital ◽  
Tikur Anbessa Specialized Hospital

Abstract Background Cancer is one of the leading causes of death in the world and it is considered that every fourth person dies of it. Under-nutrition is most commonly seen in cancer patients with some types of solid tumors, various chronic diseases, as well as in older persons and young children. This can result in longer hospital stay, reduced response to therapies, increased complications to therapy and surgery proceedings, poor survival and higher care costs. This study aimed to assess the prevalence and factors associated with under-nutrition on cancer patients attending Tikur Anbessa Specialized Hospital, Ethiopia.Methods Cross-sectional study was conducted from September to October 2018 among 347 cancer patients in Tikur Anbessa Specialized hospital Addis Ababa, Ethiopia. All cancer patients 18–65 years of age who were on the 2nd cycle and above treatment phase were included. Quantitative data was collected using questionnaires and the Patient Generated-Subjective Global Assessment (PG-SGA) score. Data was entered into Epi-Info version 7 and exported and analyzed by SPSS version 20. Both bivariate and multivariate logistic regression analyses were employed to identify the associated factors. Variables with 𝑃 value of less than 0.05 were considered as significant predictors.Results The prevalence of under-nutrition according to PG-SGA score result 202 (63.1%) and 88(27.5%) of the participants were moderately and severely undernourished, respectively. BMI of the participants also showed that 206 (64.4%) and 89 (27.8%) were normal and underweight, respectively. Two hundred seventy-six (86.3%) of the patients needed critical nutrition intervention. Performance status of ≥ 2 [AOR = 7.9, 95% CI (3.05, 20.48)] and cancer stage II, III & IV [AOR = 3.47, 95% CI (1.25, 9.58)], [AOR = 3.81, 95% CI (1.17, 12.31)] and [AOR = 6.11, 95% CI (1.48, 25.14)] were significantly associated with malnutrition on cancer patients at a P-value < 0.05.Conclusion The prevalence of under-nutrition is prevalent in the study area. Performance status of ≥ 2 and cancer stages were important factors associated with malnutrition in cancer patients. Screening and evaluation of nutritional status of the patients and planning nutritional therapy such as dietary supplements or enteral nutrition to counteract malnutrition on cancer patients should be implemented.

scholarly journals Extended Spectrum Beta-Lactamase Production in Uropathogens Isolated from Hospitalized Patients with Chronic Pyelonephritis

2015 ◽  
Vol 8 (1) ◽  
pp. 71-75 ◽  
Author(s):  
Olga I Chub ◽  
Aleksandr V Bilchenko ◽  
Igor Khalin
Keyword(s):  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Chronic Pyelonephritis ◽  
Diffusion Method ◽  
Beta Lactamase ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Tract Infections

Background : Increased multidrug resistance of extended-spectrum beta-lactamases (ESBLs) compromises the efficacy of treatment of urinary tract infections. Objective : The objective of this study is to determine the prevalence of ESBL-producing uropathogens from hospitalized patients with chronic pyelonephritis and to identify the presence of genes involved in the resistance. Methods : A cross-sectional study of 105 patients with chronic pyelonephritis, treated in Kharkiv City Clinical Emergency Hospital, Ukraine was carried. Bacterial isolates were collected, antimicrobial susceptibility of isolates was determined by the Kirby Bauer disk diffusion method and screening for the presence of blaSHV, blaTEM, blaCTX-M ESBL genes was performed by polymerase chain reaction. Results : 84 (80%) patients had positive urine cultures. Eschеrichia coli wаs the most common microorganism isolated. Among them, 29 (25.2%) were found to be ESBL producers. Out of 53 E. coli isolates, 10 (18.9%), 4 (7.5%) and 6 (11.3%) were identified to carry bla(TEM), bla(SHV) and bla(CTX-M) beta-lactamase genes, respectively. The highest resistance was observed against ampicillin (75.9%), ciprofloxacin (48.3%), levofloxacin (41.4%) and gentamicin (41.4%). Beside this, only meropenem (96.6% susceptibility), nitroxolinum (86.2%) and fosfomycin (72.4%) exhibited a good enough activity against ESBLs-producing urinary strains. Conclusion : Isоlation and detеction of ESBL-prоducing strаins are еssential fоr the sеlection оf the mоst effеctive antibiоtic for the empiric trеatment.

scholarly journals Prevalence of Extended Spectrum Beta Lactamase Producing and Carbapenems Resistance Isolates from Hands of Health Care Workers in a Health Care Setting of Nepal

2020 ◽  
Vol 13 (1) ◽  
pp. 23-31
Author(s):  
Binita Koirala Sharma
Keyword(s):  
Health Care ◽  
Antibiotic Susceptibility ◽  
Cross Sectional Study ◽  
Control Measures ◽  
Resistant Bacteria ◽  
Beta Lactamase ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum

Background: Hands of healthcare workers (HCWs) could be colonized by potential drug resistant bacteria like Extended Spectrum Beta Lactamase producers (ESBLs) and Carbapenems-resistant (CR) isolates and could become vectors of nosocomial pathogens in healthcare facilities that are associated with an increase of morbidity, mortality and healthcare costs. This study aimed to investigate the prevalence of ESBLs and CR isolates from hands of HCWs with their antibiotic susceptibility pattern. Materials and methods: This was a cross-sectional study that included a total of 150 hand swabs collected from March, 2018 to September, 2018 in Gandaki Medical College and Teaching Hospital. Isolation, identification and antimicrobial susceptibility tests were done using standard microbiological procedures. Results: Among the total isolates of 219 obtained from growth positive samples 92/219(42.01%) were Gram negative bacteria (GNB) and the most common were Klebsiella spp 32(34.78%) followed by Escherichia coli 17(18.48%), Pseudomonas aeruginosa12 (13.04%), Acenetobacter spp 11(11.96%), Proteus spp 9(9.78%), Citrobacter spp 7(7.61%) and Enterobacter spp 4(4.35%). The prevalence of ESBLs, CR and ESBLs with Co-resistant to Carbapenems were 19.56%,14.13% and 9.78%, respectively. The most effective drugs for isolates were Nitrofurantoin followed by Amikacin, Tetracycline and Gentamycin. Distribution pattern of the ESBLs and CR isolates among doctors, nurses, laboratory technicians, helpers and basic science faculties were not significant (p>0.05). Conclusions: This report revealed the emerging and moderately high prevalence of ESBLs, CR and ESBLs with Co-resistant to Carbapenems GNB with their antibiotic susceptibility patterns found on hands of HCWs in Nepal. Thus, this study could be helpful in developing proper guidelines on hand hygiene and implementation of infection control measures including contact precautions against the spread of infections by such pathogens in healthcare settings.  

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