scholarly journals Magnitude and antimicrobial susceptibility patterns of extended-spectrum β-lactamase producing Enterobacteriaceae recovered from environmental samples at Tikur Anbessa Specialized Hospital, Ethiopia

2020 ◽  
Author(s):  
Shemse Sebre Muktar ◽  
Woldaregay Erku ◽  
Wude Mihret ◽  
Aminu Seman ◽  
Tewachw Awoke ◽  
...  
Keyword(s):  
High Resistance ◽  
Antimicrobial Susceptibility ◽  
Hospital Environment ◽  
Diffusion Method ◽  
Resistance Level ◽  
Cross Sectional ◽  
Extended Spectrum ◽  
Specialized Hospital ◽  
Tikur Anbessa Specialized Hospital ◽  
Susceptibility Patterns

Abstract Background The hospital environment especially the intensive care units (ICUs) contributes to the spread of extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae, which are contributing to increasing morbidity and mortality rates. We aimed to assess the rate of environmental contamination of ESBL producing Enterobacteriaceae and their antimicrobial susceptibility patterns. Methods A Cross-sectional study was conducted at Tikur Anbessa Specialized Hospital (TASH) from June to July, 2018. A total of 65 environmental swab were taken from inanimate items. All isolates from the inanimate environment were cultured by using ESBL ChromoSelect Agar and identified using conventional bacteriological methods. All ESBL producing Enterobacteriaceae isolates were tested for their antimicrobial susceptibility using the disc diffusion method according to the methods and interpretive criteria of the Clinical and Laboratory Standards Institute (CLSI). Results From a total of 65 environmental swab samples, 16 (24.6%) were ESBL producing Enterobacteriaceae. The most predominant ESBL producing isolates were E. coli (8/16, 50%) and Klebsiella spp (6/16, 37.6%). The Pediatrics and Medical-Surgical ICU exhibited the highest ESBL producing Enterobacteriaceae, each with (37.5%, 6/16). Linens and ventilators were associated with high rates of ESBL isolates positivity each with equal 31.3% detection rate. ESBL producing Enterobacteriaceae isolates had significantly high resistance level to ampicillin (100%), ceftazidime (93.8%), cefepime (87.5%) and cefotaxime (86.7%). However, low resistance level was recorded against amikacin (18.8%). Conclusion The appearance of ESBL producing Enterobacteriaceae among ICUs hospital environment is posing a serious threat for the control of nosocomial infections. The high resistance found from this study shows the need for policies for devising infection control procedures and screening policies for ESBL on a routine basis.

scholarly journals The Magnitude and Drug Resistance Profile of Extended Spectrum Β-Lactamase (Esbl) Producing Gram-Negative Bacteria from Different Inanimate Objects at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

2021 ◽  
Author(s):  
Asegedech Asmamaw Jemberu ◽  
Kassu Desta Tullu ◽  
Yimtubeznash Woldeamanuel Mulate
Keyword(s):  
Drug Resistance ◽  
Confirmatory Test ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Resistance Profile ◽  
Extended Spectrum ◽  
Specialized Hospital ◽  
Tikur Anbessa Specialized Hospital ◽  
Drug Resistance Profile

Abstract Background: Infections caused by gram-negative bacteria are causing morbidity and mortality worldwide. The production of extended-spectrum β-lactamases (ESBLs) is an important mechanism that is responsible for resistance to the third-generation cephalosporin. The purpose of this study was to determine the magnitude and drug resistance profile of ESBL producing gram-negative bacteria isolated from various inanimate objects at Tikur Anbessa Specialized Hospital. Methods: Laboratory based cross-sectional study was conducted involving a total of 216 isolates from January to March 2019. The samples were taken from different inanimate objects at Tikur Anbessa Specialized Hospital using pre-moistened sterile swabs. Screening of ESBLs was done using ESBL CHROME agar and confirmed with combined disk diffusion test. Antimicrobial susceptibility testing was done by disc diffusion method. The data were analyzed using SPSS software version 20 and descriptive statistical tests were performed. Results: 33/216 (15.3%) isolates were found to be ESBL producers based on the confirmatory test (combined disk method). Different ESBL producing gram-negative bacteria were isolated from the various inanimate objects of TASH including, Klebsiella ozaenae, Klebsiella oxytoca, Klebsiella pneumoniae, Klebsiella rhinoscleromatis, Citrobacter spp, Escherichia coli, Serriatia spp and Acinetobacter spp. The isolates were found to be 100% resistant to ceftazidime and ceftriaxone. Conclusion: It is worrisome to detect ESBL producing gram-negative bacteria from the inanimate objects of TASH, calling for systematic screening of inanimate objects for ESBL and other multidrug-resistant bacteria in the hospital. Furthermore, strengthening the infection prevention practice is vital to halt the transmission of these microorganisms.

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 Antimicrobial Resistance Profiles and associated factors of Acinetobacter and Pseudomonas aeruginosa nosocomial infection among patients admitted at Dessie comprehensive specialized Hospital, North-East Ethiopia. A cross sectional study

2021 ◽  
Author(s):  
Habtamu Mekonnen ◽  
Abdurahaman Seid ◽  
Genet Molla ◽  
Teklay Gebrecherkos
Keyword(s):  
Antimicrobial Resistance ◽  
Nosocomial Infection ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Hospital Environment ◽  
Diffusion Method ◽  
Sectional Study ◽  
Cross Sectional ◽  
North East ◽  
Specialized Hospital

Abstract Background:- Hospital admitted patients are at increased risk of nosocomial infections (NIs) with multi-drug resistant (MDR) pathogens which are prevalent in the hospital environment. P. aeruginosa and A. baumannii are common causes of NIs worldwide. The objective of this study is to determine the magnitude, antimicrobial resistance profiles, and associated factors of Acinetobacter and P. aeruginosa NIs among patients hospitalized at Dessie Comprehensive Specialized Hospital (DCSH), North-East Ethiopia.Methods:- A cross-sectional study was conducted at DCSH from February 1 to April 30, 2020. A total of 254 patients who were suspected of either bloodstream, urinary tract, or surgical site nosocomial infection were enrolled consecutively. Sociodemographic and other variables of interest were collected using a structured questionnaire. The specimens were collected and processed following standard microbiological procedures. Antibacterial susceptibility was determined by the Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. Data were analyzed with SPSS version 23 and p-value < 0.05 was considered to be statistically significant.Results: Overall, 13% of patients had nosocomial Acinetobacter and/or P. aeruginosa infections. The culture positivity rate was 16(6.3%) for Acinetobacter spp and 18(7.1%) for P. aeruginosa. All isolates of Acinetobacter spp. were from patients with intravenous catheterization. Patients admitted in the surgical ward (Adjusted odds ratio (AOR): 10.66; 95% confidence interval (CI): 1.22-93.23), pediatric ward (AOR: 14.37; 95% CI: 1.4-148.5), intensive care unit (AOR: 41.93; 95% CI:4.7-374.7) and orthopedics (AOR: 52.21;95%CI:7.5-365) were significantly at risk to develop NIs compared to patients admitted in the medical ward. Patients who took more than two antimicrobial types were 94% (AOR: 0.06; 95% CI: 0.004-0.84) times more protected from NIs compared to those who did not take any antimicrobial. About 81% of Acinetobacter spp. and 83% of P. aeruginosa isolates were MDR. Amikacin and meropenem showed promising activity against Acinetobacter and P. aeruginosa isolates.Conclusion: The high prevalence of MDR Acinetobacter and P. aeruginosa nosocomial isolates highlighted the need of improving and implementing infection control programs in the hospitals. Treatment of NIs should be guided by antimicrobial susceptibility testing.

scholarly journals Streptococcal Throat Carriage among Primary School Children Living in Uyo, Southern Nigeria

2021 ◽  
Vol 11 (01) ◽  
pp. e28-e34
Author(s):  
Kevin B. Edem ◽  
Enobong E. Ikpeme ◽  
Mkpouto U. Akpan
Keyword(s):  
Primary School ◽  
School Children ◽  
Antimicrobial Susceptibility ◽  
Group A Streptococcus ◽  
Latex Agglutination ◽  
Sub Saharan Africa ◽  
Primary School Children ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Cross Sectional

AbstractSurveillance of the carrier state for β-hemolytic streptococcal (BHS) throat infections remains essential for disease control. Recent published works from Sub-Saharan Africa have suggested a changing epidemiology in the burden of BHS throat infections. The objective of the present study was therefore to determine the prevalence and pattern of BHS throat carriage in school-aged children in Uyo, Akwa Ibom State. This was a prospective cross-sectional study of 276 primary school children in Uyo. Subjects were recruited by multistage random sampling. Obtained throat swabs were cultured on 5% sheep blood agar. Lancefield grouping on positive cultures was done by using the Oxoid Streptococcal Grouping Latex Agglutination Kit, United Kingdom. Antimicrobial susceptibility testing was done with the disk diffusion method. Associations were tested with Fischer's exact test. The prevalence of BHS carriage was 3.3%. Group C Streptococcus was identified in 89% of isolates and Group G Streptococcus in 11%. Younger age and larger household size were associated with asymptomatic streptococcal throat infections. Antimicrobial susceptibility was highest with cefuroxime and clindamycin (89% of isolates each), while 78% of isolates were susceptible to penicillin. None of the tested isolates was susceptible to co-trimoxazole. The prevalence of streptococcal throat carriage in the study area was low. There were no Group A Streptococcus isolates suggesting an evolving epidemiology of BHS disease in the study area.

Prevalence and Antibiogram of Extended-Spectrum Beta-Lactamase Producing Gram-negative Bacteria Isolated from Septicemic Neonates in a Tertiary Care Hospital

KYAMC Journal ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 171-175
Author(s):  
Tania Rahman ◽  
Momtaz Begum ◽  
Sharmeen Sultana ◽  
SM Shamsuzzaman
Keyword(s):  
Antimicrobial Susceptibility ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Blood Samples ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Esbl Producers

Background: In recent years, Extended-spectrum beta-lactamase (ESBL) producing microorganisms have complicated treatment of infections due to resistance of ESBL producing strains to a wide range of antimicrobials. Objective: Target of this study was to determine the prevalence of ESBL producing gramnegative bacteria in neonatal sepsis cases and to reveal the antimicrobial susceptibility pattern of those isolated ESBL producers. Materials and Methods: This cross sectional study was carried out in Dhaka Medical College Hospital (DMCH) over a period of 12 months from January to December in 2016. Following isolation and identification of gram-negative bacteria from blood samples of suspected septicemic neonates, antimicrobial susceptibility test was performed by Kirby Bauer disk-diffusion method and ESBL producers were detected by Double Disk Synergy (DDS) test. Results: Among 52 Gram-negative bacteria isolated from 106 blood samples, 34.61% ESBL producers were detected and Enterobacter spp. (45%) was predominant followed by Klebsiella pneumoniae (33.33%). None of the ESBL producers was resistant to colistin and tigecycline. All ESBL producing Acinetobacter baumannii, 77.78% and 66.67% of ESBL producing Enterobacter spp and Klebsiella spp. respectively showed resistance to meropenem. All ESBL producers were resistant to piperacillintazobactam. Conclusion: Appropriate measures should be taken to prevent the spread of ESBL producing strains by combining strategies for infection prevention, control and rational use of antibiotics. KYAMC Journal Vol. 11, No.-4, January 2021, Page 171-175

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, Risk Factors, and Antibiogram of Nontyphoidal Salmonella from Beef in Ambo and Holeta Towns, Oromia Region, Ethiopia

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Endrias Zewdu Gebremedhin ◽  
Gezahegn Tafesse Soboka ◽  
Bizunesh Mideksa Borana ◽  
Lencho Megersa Marami ◽  
Edilu Jorga Sarba ◽  
...  
Keyword(s):  
Risk Factors ◽  
Food Safety ◽  
Antimicrobial Susceptibility ◽  
Multidrug Resistant ◽  
Animal Origin ◽  
Diffusion Method ◽  
Isolation And Identification ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Food Of Animal Origin

Background. Salmonella has been recognized as a major cause of food-borne illness associated with the consumption of food of animal origin. The present cross-sectional study was conducted from December 2017 to May 2018 in Ambo and Holeta towns to assess the prevalence, risk factors, and antimicrobial susceptibility patterns of nontyphoidal Salmonella isolates from raw beef samples from abattoirs, butchers, and restaurants in Ambo and Holeta towns, Oromia region, Ethiopia. Methods. A total of 354 beef samples were collected from abattoirs, butchers, and restaurants. Salmonella isolation and identification were carried out using standard bacteriological methods recommended by the International Organization for Standardization. Antimicrobial susceptibility testing was performed using the disk diffusion method. Besides, a structured questionnaire was used to collect sociodemographic data and potential risk factors for contamination of meat. Chi-square tests and logistic regression were used for data analyses. Results. Of the total 354 meat samples examined, 20 (5.7%, 95% confidence interval (CI): 3.5–8.6) were positive for Salmonella. Two serotypes belonging to S. typhimurium (11 isolates) and I:4,5,12: i:- (9 isolates) were identified. The Salmonella detection rate in abattoirs, butchers, and restaurants was 4.2% (5/118), 8.5% (10/118), and 4.2% (5/118), respectively. The antimicrobial susceptibility test showed that 40%, 30%, and 20% of the Salmonella isolates were resistant to azithromycin, amoxicillin, and ceftriaxone, respectively. The odds of Salmonella isolation when meat handlers are illiterate were 7.8 times higher than those when they are educated to the level of secondary and above ( P = 0.032 ). Similarly, the likelihood of Salmonella isolation was 6.3 and 7.6 times higher among workers of butcher and restaurants, respectively, who had no training ( P = 0.003 ) and no knowledge ( P = 0.010 ) on food safety and hygiene. Conclusions. The study showed widespread multidrug-resistant Salmonella isolates in the study areas. Therefore, raw meat consumption and indiscriminate use of antimicrobial drugs should be discouraged. Provision of food safety education for meat handlers and further surveillance of antimicrobial-resistant isolates are suggested.

scholarly journals Antimicrobial susceptibility of Pasteurella multocida isolated from sheep and pigs in Spain – Short communication

2019 ◽  
Vol 67 (4) ◽  
pp. 489-498
Author(s):  
Dolores Cid ◽  
José Francisco Fernández-Garayzábal ◽  
Chris Pinto ◽  
Lucas Domínguez ◽  
Ana Isabel Vela
Keyword(s):  
High Resistance ◽  
Antimicrobial Susceptibility ◽  
Pasteurella Multocida ◽  
Antimicrobial Agents ◽  
Empirical Therapy ◽  
Microdilution Method ◽  
Low Levels ◽  
Resistance Rates ◽  
Farming Industry ◽  
Susceptibility Patterns

Pasteurella multocida is responsible for economically important diseases in sheep and pigs. Antimicrobial susceptibility studies are essential for initiating rational and effective empirical therapy of P. multocida infections. In this study we investigated the antimicrobial susceptibility to 18 antimicrobial agents of 156 clinical isolates of P. multocida from sheep (n = 87) and pigs (n = 69) using the microdilution method. Both sheep and pig isolates exhibited low levels of resistance (≤ 15%) to ceftiofur, gentamicin, neomycin, spectinomycin, chlortetracycline, tulathromycin, florfenicol, danofloxacin, and enrofloxacin and trimethoprim/sulphamethoxazole, high resistance rates (> 15% up to 50%) to oxytetracycline, tilmicosin, and tiamulin, and very high resistance rates (> 50%) to tylosin tartrate, clindamycin, and sulphadimethoxine. However, sheep isolates exhibited significantly lower percentages of resistance and lower MIC90 values (P < 0.05) than pig isolates for most of the antimicrobials tested. In addition, sheep isolates exhibited also significantly lower phenotypic antimicrobial resistance diversity (8 resistotypes vs. 30 resistotypes). LAC-LIN-SUL-MAC was the resistotype most frequently detected in sheep (39.1%) and LIN-SUL-MAC in pig isolates (26.1%). The differences in susceptibility patterns could be influenced by the lower use of antimicrobials in the small ruminant industry compared with the pig farming industry.

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