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Legese Chelkeba ◽  
Korinan Fanta ◽  
Temesgen Mulugeta ◽  
Tsegaye Melaku

Abstract Background Globally, antimicrobial resistance (AMR) restricted the armamentarium of the health care providers against infectious diseases, mainly due to the emergence of multidrug resistant. This review is aimed at providing contemporary bacterial profile and antimicrobial resistance pattern among pregnant women with significant bacteriuria. Methods Electronic biomedical databases and indexing services such as PubMed/MEDLINE, Web of Science, EMBASE and Google Scholar were searched. Original records of research articles, available online from 2008 to 2021, addressing the prevalence of significant bacteriuria and AMR pattern among pregnant women and written in English were identified and screened. The relevant data were extracted from included studies using a format prepared in Microsoft Excel and exported to STATA 14.0 software for the outcome measure analyses and subgrouping. Results The data of 5894 urine samples from 20 included studies conducted in 8 regions of the country were pooled. The overall pooled estimate of bacteriuria was 15% (95% CI 13–17%, I2 = 77.94%, p < 0.001) with substantial heterogeneity. The pooled estimate of Escherichia coli recovered from isolates of 896 urine samples was 41% (95% CI 38–45%) followed by coagulase-negative Staphylococci, 22% (95% CI 18–26%), Staphylococcus aureus, 15% (95% CI 12–18%), Staphylococcus saprophytic, 12% (95% CI 6–18%) Proteus mirabilis, 7% (95% CI 4–10%), Enterococcus species, 6% (0–12%), Pseudomonas aeruginosa, 4% (2–6%), Citrobacter species, 4% (95% CI 2–4%), Group B streptococcus, 3% (1–5%), and Enterobacter species, 2% (1–4%). Multidrug resistance proportions of E. coli, Klebsiella species, Staphylococcus aureus and Coagulase negative staphylococci, 83% (95% CI 76–91%), 78% (95% CI 66–90%), 89% (95% CI 83–96%), and 78% (95% CI 67–88%), respectively. Conclusion The result of current review revealed the occurrence of substantial bacteriuria among pregnant women in Ethiopia. Resistance among common bacteria (E. coli, Klebsiella species, Staphylococci species) causing UTIs in pregnant women is widespread to commonly used antibiotics. The high rate of drug resistance in turn warrants the need for regular epidemiological surveillance of antibiotic resistance and implementation of an efficient infection control and stewardship program.

2022 ◽  
Vol 18 (1) ◽  
Belisa Usmael ◽  
Bruk Abraha ◽  
Sisay Alemu ◽  
Bahar Mummed ◽  
Adem Hiko ◽  

Abstract Background Dogs are one of the important asymptomatic carriers of antimicrobial resistant and potentially pathogenic strains of Salmonella. They can harbor large bacterial load in the intestines and mesenteric lymph nodes which can be shed in their feces with the possibility of transmission to humans. Therefore, a cross-sectional study was conducted with the objectives of estimating the prevalence of non-typhoidal Salmonella, assessing the risk factors for dog’s Salmonella carriage, and profiling the antimicrobial resistance pattern of Salmonella isolates among housed dogs in Harar town, Eastern Ethiopia. A total of 415 rectal swab samples were collected from randomly selected dogs. Samples were examined for non-typhoidal Salmonella using standard bacteriologic culture and biochemical tests. The disk diffusion method (Kirby-Bauer test) was employed to evaluate the isolates for their susceptibility against five antimicrobials. Results Non-typhoidal Salmonella were isolated from 26 (6.3%) of the rectal swab samples, with significantly higher occurrence in diarrheic (15.2%) than non-diarrheic (5.5%) dogs. The risk of Salmonella harboring was significantly higher in female dogs than in male dogs (OR = 2.5, p = 0.027). Dogs fecal shedding of Salmonella was relatively higher in households who used offal as a main feed type for their dogs (23.1%; 95% CI = 5–53.8) than those who used leftover food (10.1%; 95% CI = 5.7–16.1) and practiced mixed feeding system (17%; 95% CI = 7.6–30.8). Salmonella isolates showed higher resistance to ampicillin (41.7%), while all isolates were fully susceptible to gentamicin. Moreover, 58.3% of Salmonella isolates showed resistance to at least one of the tested antimicrobials. Majorities (72.7%) of the dog owners had no awareness on the risk of zoonotic salmonellosis from dog and all of the respondents use bare hand to clean dog kennel. Conclusion Our study reveals the importance of both diarrheic and apparently healthy housed dogs in the harboring and shedding of antimicrobial resistant non-typhoidal Salmonella. The risk of non-typhoidal Salmonella spread among pet owners is not negligible, especially in households who use offal as main feed type. Therefore, an integrated approach such as: proper dog handling practices; continuous evaluation of antimicrobial resistance; and rational use of antimicrobials in the field of veterinary sector are necessary to tackle the problem.

Tafese Beyene Tufa ◽  
Colin R. Mackenzie ◽  
Hans Martin Orth ◽  
Tobias Wienemann ◽  
Tamara Nordmann ◽  

Abstract Background Infectious diseases are among the leading causes of death in many low-income countries, such as Ethiopia. Without reliable local data concerning causative pathogens and antimicrobial resistance, empiric treatment is suboptimal. The objective of this study was to characterize gram-negative bacteria (GNB) as pathogens and their resistance pattern in hospitalized patients with infections in central Ethiopia. Methods Patients ≥ 1 year of age with fever admitted to the Asella Referral and Teaching Hospital from April 2016 to June 2018 were included. Blood and other appropriate clinical specimens were collected and cultured on appropriate media. Antibiotic susceptibility testing (AST) was performed using the Kirby–Bauer method and VITEK® 2. Species identification and detection of resistance genes were conducted using MALDI-ToF MS (VITEK® MS) and PCR, respectively. Results Among the 684 study participants, 54.2% were male, and the median age was 22.0 (IQR: 14–35) years. Blood cultures were positive in 5.4% (n = 37) of cases. Among other clinical samples, 60.6% (20/33), 20.8% (5/24), and 37.5% (3/8) of swabs/pus, urine and other body fluid cultures, respectively, were positive. Among 66 pathogenic isolates, 57.6% (n = 38) were GNB, 39.4% (n = 26) were gram-positive, and 3.0% (n = 2) were Candida species. Among the isolated GNB, 42.1% (16/38) were Escherichia coli, 23.7% (9/38) Klebsiella pneumoniae and 10.5% (4/38) Pseudomonas aeruginosa. In total, 27/38 gram-negative isolates were available for further analysis. Resistance rates were as follows: ampicillin/sulbactam, 92.6% (n = 25); cefotaxime, 88.9% (n = 24); ceftazidime, 74.1% (n = 20); cefepime, 74.1% (n = 20); gentamicin, 55.6% (n = 15); piperacillin/tazobactam, 48.1% (n = 13); meropenem, 7.4% (n = 2); and amikacin, 3.7% (n = 1). The blaNDM-1 gene was detected in one K. pneumoniae and one Acinetobacter baumannii isolate, which carried an additional blaOXA-51 gene. The ESBL enzymes were detected in 81.5% (n = 22) of isolates as follows: TEM, 77.2% (n = 17); CTX-M-1 group, 68.2% (n = 15); SHV group, 27.3% (n = 6); and CTX-M-9 group, 9.1% (n = 2). Based on the in vitro antimicrobial susceptibility results, empiric treatment initiated in 13 of 18 (72.2%) patients was likely ineffective. Conclusion We report a high prevalence of ESBL-producing bacteria (81.5%) and carbapenem resistance (7.4%), with more than half of GNB carrying two or more ESBL enzymes resulting in suboptimal empiric antibiotic therapy. These findings indicate a need for local and national antimicrobial resistance surveillance and the strengthening of antimicrobial stewardship programs.

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262597
Tebelay Dilnessa ◽  
Alem Getaneh ◽  
Workagegnehu Hailu ◽  
Feleke Moges ◽  
Baye Gelaw

Background Clostridium difficile is the leading cause of infectious diarrhea that develops in patients after hospitalization during antibiotic administration. It has also become a big issue in community-acquired diarrhea. The emergence of hypervirulent strains of C. difficile poses a major problem in hospital-associated diarrhea outbreaks and it is difficult to treat. The antimicrobial resistance in C. difficile has worsened due to the inappropriate use of broad-spectrum antibiotics including cephalosporins, clindamycin, tetracycline, and fluoroquinolones together with the emergence of hypervirulent strains. Objective To estimate the pooled prevalence and antimicrobial resistance pattern of C. difficile derived from hospitalized diarrheal patients, a systematic review and meta-analysis was performed. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to review published studies conducted. We searched bibliographic databases from PubMed, Scopus, Google Scholar, and Cochrane Library for studies on the prevalence and antimicrobial susceptibility testing on C. difficile. The weighted pooled prevalence and resistance for each antimicrobial agent was calculated using a random-effects model. A funnel plot and Egger’s regression test were used to see publication bias. Results A total of 15 studies were included. Ten articles for prevalence study and 5 additional studies for antimicrobial susceptibility testing of C. difficile were included. A total of 1967/7852 (25%) C. difficile were isolated from 10 included studies for prevalence study. The overall weighted pooled proportion (WPP) of C. difficile was 30% (95% CI: 10.0–49.0; p<0.001). The analysis showed substantial heterogeneity among studies (Cochran’s test = 7038.73, I2 = 99.87%; p<0.001). The weighed pooled antimicrobial resistance (WPR) were: vancomycin 3%(95% CI: 1.0–4.0, p<0.001); metronidazole 5%(95% CI: 3.0–7.0, p<0.001); clindamycin 61%(95% CI: 52.0–69.0, p<0.001); moxifloxacin 42%(95% CI: 29–54, p<0.001); tetracycline 35%(95% CI: 22–49, p<0.001); erythromycin 61%(95% CI: 48–75, p<0.001) and ciprofloxacin 64%(95% CI: 48–80; p< 0.001) using the random effect model. Conclusions A higher weighted pooled prevalence of C. difficile was observed. It needs a great deal of attention to decrease the prevailing prevalence. The resistance of C. difficile to metronidazole and vancomycin was low compared to other drugs used to treat C. difficile infection. Periodic antimicrobial resistance monitoring is vital for appropriate therapy of C. difficile infection.

2022 ◽  
Vol 204 (2) ◽  
Gururaj Kumaresan ◽  
Chetna Gangwar ◽  
Anil Kumar Mishra ◽  
Ashok Kumar ◽  
Suresh Dinkar Kharche ◽  

Sushma Yadav Boorgula ◽  
Sadhana Yelamanchili ◽  
Pragathi Kottapalli ◽  
Mohini D. Naga

Abstract Introduction Since coronavirus disease 2019 (COVID-19) has limited treatment options, concern has been raised over secondary infections and antimicrobial resistance (AMR) patterns. It has been observed that patients who were infected with COVID-19 were predisposed to develop secondary infections. The purpose of the study is to ascertain the prevalence of the bacterial and fungal coinfections in COVID-19 patients, and also to assess the AMR patterns in the obtained isolates. Methods We have studied 200 clinical samples obtained from 122 COVID-19 positive patients. Pathogens were identified using Vitek 2 system. The demographic and clinical patterns were also observed. Results A total of 122 patients developed secondary infections. Patients aged more than 40 years were majorly affected (p-value < 0.0001). Respiratory samples (n = 96) were predominant. Klebsiella pneumoniae (n = 68) was the most common pathogen isolated followed by Acinetobacter baumannii (n = 54) and an overall 6% rise in the Carbapenem resistance was observed in the isolates. Conclusion To contain the secondary infections in COVID-19 patients, it is imperative to adhere to antimicrobial stewardship program and timely revise the empirical antibiotic policy.

2022 ◽  
Vol 52 (8) ◽  
Paulo Eduardo Carraro ◽  
Fernanda de Oliveira Barbosa ◽  
Valdinete Pereira Benevides ◽  
Monique Ribeiro Tiba Casas ◽  
Angelo Berchieri Junior ◽  

ABSTRACT: European wild boars (Sus scrofa) are considered exotic invasive species worldwide. Invasions of wild boars are a growing public health concern, as wild boars may represent an important reservoir of zoonotic pathogens, including bacteria of the genus Salmonella. The aim of this study was to determine the prevalence and serovars of Salmonella spp. in free-ranging wild boars legally hunted in the state of São Paulo, Brazil, and the susceptibility of those Salmonella spp. to antimicrobials. Fecal samples and mesenteric lymph nodes were acquired from 63 wild boars. The prevalence of Salmonella spp. in free-ranging wild boars was 9.5 % (6/63; confidence interval: 4.4 % - 19.2 %). Six serovars were isolated: S. enterica subsp. enterica ser. 4,5,12:-:1,2, S. enterica ser. Cerro, S. enterica ser. Madelia, S. enterica ser. Typhimurium, S. enterica ser. I (4,5,12:i:-) and S. enterica ser. Muenster. Analysis of antimicrobial resistance of Salmonella spp. showed that the majority of serovars were fully susceptible to the tested antimicrobials. Only S. enterica ser. Typhimurium and S. enterica ser. Muenster showed a resistance pattern to at least one antimicrobial analyzed. To our knowledge, this study is the first report the prevalence and serovars of Salmonella spp. in free-ranging wild boars in the State of São Paulo, Brazil. Results indicate a low prevalence with variability of Salmonella serovars, with some pattern of antimicrobial resistance. This study highlights the potential role of wild boars as carriers of Salmonella and could pose a risk to wild and domestic animals as well as humans.

2022 ◽  
Vol 13 (1) ◽  
pp. 88-92
M Swapna ◽  
G Sumathi ◽  
M Anitha

Background: Pseudomonas aeruginosa is one of the most prevalent nosocomial pathogens that cause a life-threatening infection. One of the important characteristics of P. aeruginosa is biofilm formation which leads to antibiotic resistance. Aims and Objectives: The aim of the study was to study the antibiotic resistance pattern of P. aeruginosa isolates and correlation with their biofilm-production. Materials and Methods: A total of 87 P. aeruginosa isolates from different clinical specimens were processed and confirmed by conventional microbiological methods as per standard methodology. Antibiotic sensitivity testing was done for all isolates. Biofilm producing isolates were identified by the microtiter plate method (MTPM). Results: Of 87 P. aeruginosa isolates, majority were from pus 33 (38%), followed by urine 26 (30%), sputum 19 (22%), body fluids 7 (8%), and blood 2 (2%). Biofilm producing isolates showed more resistance in comparison to non-biofilm producers. The observed difference between biofilm formation for multidrug resistant and susceptible isolates was found to be statistically significant. Conclusion: MTPM method was an effective test for detection of biofilm formation and was also able to verify biofilm production by P. aeruginosa. This indicated a higher propensity among the clinical isolates of P. aeruginosa to form biofilm and revealed a positive correlation between biofilm formation and antibiotic resistance. This indicates the need for testing of even susceptible isolates for virulence factors such as biofilm production.

2021 ◽  
Vol 3 (1) ◽  
Hassan Rania ◽  
El-Gilany Abdel-Hady ◽  
Elaal Amina M Abd ◽  
El-Mashad Noha ◽  
Abdelazim Dalia

2021 ◽  
Vol 11 (1) ◽  
pp. 14-16
Md Mobarok Hossain ◽  
Tasnim Jabin ◽  
Md Ifrat Hossain ◽  
Mst Arzina Khatun ◽  
Md Hossain Emam ◽  

The study was conducted to detect the antibiotic resistance profile of the clinical isolates of Salmonella enterica Serovar Paratyphi A from 100 blood samples of patients from different age groups suspected to be suffering from enteric fever. The pure cultures of the bacterial isolates were collected from some renowned diagnostic centers of Dhaka and they were further characterized through the conventional culture, microscopy and biochemical examinations. These isolates were cross checked for the antibiogram profile by the Kirby-Bauer disc diffusion method against ten different types of antibiotics. Most of the isolates were found resistant against azithromycin (100%), nalidixic acid (100%) and ceftazidime (75%). However, isolates showed sensitivity to ciprofloxacin (95%), levofloxacin (97%), cotrimoxazole (96%) and chloramphenicol (95%). These findings highlight the need for continuous monitoring of the drug resistance pattern of S. enterica Serovar Paratyphi A for better public health management. Stamford Journal of Microbiology, Vol.11 (1) 2021: 14-16

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