A systematic review: the current status of carbapenem resistance in East Africa

Abstract

ObjectiveIn this systematic review, we present the molecular epidemiology and knowledge gaps of the carbapenem resistance in East Africa as well as the future probable research interventions that can be used to address the emergence of carbapenem resistance in the region.ResultsThe 17 articles which presented concrete information about the prevalence of carbapenem resistance in East Africa were reviewed. Tanzania exhibited the highest level of carbapenem resistance at 35% while DRC had the lowest level at 0.96%. Uganda was the only country with studies documenting CR obtained amongst hospital environment isolates with incidence ranging from 21% in Pseudomonas aeruginosa to 55% in Acinetobacter baumannii. Carbapenem resistance was more exhibited in A. baumannii (23%), followed by P. aeruginosa (17%), Klebsiella pneumoniae (15%), Proteus mirabilis (14%) and Escherichia coli (12%) mainly isolated from respiratory tract, blood, urine and wound/pus. The regional genetic determinants of carbapenem resistance detected were blaIMP, blaVIM-1 blaSPM-l, blaNDM-1, blaOXA-23 blaOXA-24, blaOXA-58 and blaKPC.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3738-2) contains supplementary material, which is available to authorized users.

Antimicrobial Resistance Profiles and Clonal Relatedness of <i>Pseudomonas aeruginosa</i> Strains Recovered from Wounds Infections of Outpatient Population Presenting in a Rural Hospital in Kenya

“…Resistance to carbapenem which is the last resort was also recorded (MEM, 40%). Our findings therefore show an increase in carbapenem resistance in East Africa as compared to a systematic review done in the region that reported an incidence of 21% [14]. Tazobactam-Piperacillin the most used anti-Pseudomonal agent was effective to most isolates that were resistant to other antimicrobials Resistance to third generation β-lactams such as CAZ has been attributed to carriage of β-lactamases [15] bla NDM carriage was positive in only 10 from a total of 34 isolates that were resistant to Meropenem.…”

Antibiotic resistance in patients with clinical features of healthcare-associated infections in an urban tertiary hospital in Sierra Leone: a cross-sectional study

“…Unlike a systematic review on ESBL-producing organisms in Africa [28], a high rate of ESBL-producing gramnegative bacteria was detected in this study (58.0% vs 22.8%). Nonetheless, carbapenem-resistance rate in A. baumannii, P. aeruginosa, and Enterobacteriaceae were lower than reported in other LMICs [29,30] and some high-income countries [31]. These patterns of antibiotic resistance in this setting could be explained by the high rate of use of third generation cephalosporins and a lack in exposure of admitted patients in this hospital to carbapenems [26].…”

Urban and agricultural soils in Southern California are a reservoir of carbapenem‐resistant bacteria

“…Carbapenem‐resistant bacteria are a major public health threat all over the world (Centers for Disease Control & Prevention, 2013a, 2013b; Cuzon et al, 2011; Guh et al, 2015). However, little is still known about the distribution and characteristics of CRB outside health care or immediately related settings (Gupta et al, 2011; Kallen et al, 2010; Khuntayaporn et al, 2012; Rhomberg & Jones, 2009; Ssekatawa et al, 2018). This gap in knowledge is especially significant in the United States, where only three specific studies about the prevalence of CRB in the environment, all three in freshwater, have been performed (Ash et al, 2002; Aubron et al, 2005; Harmon et al, 2019).…”

“…Because the use of carbapenems is restricted to healthcare facilities (Bradley et al, 1999; Paterson, 2000), most studies on isolating and characterizing CRB have also focused on these and immediately related settings (Gupta, Limbago, Patel, & Kallen, 2011; Kallen, Hidron, Patel, & Srinivasan, 2010; Khuntayaporn, Montakantikul, Mootsikapun, Thamlikitkul, & Chomnawang, 2012; Rhomberg & Jones, 2009; Ssekatawa, Byarugaba, Wampande, & Ejobi, 2018). However, other β‐lactams including extended‐spectrum penicillins and cephalosporins are used to treat patients outside healthcare facilities and are used in agriculture as well.…”