Emergence of High Prevalence of Extended-Spectrum Beta-Lactamase and Carbapenemase Producing Acinetobacter Species and Pseudomonas aeruginosa Among Hospitalized Patients at Dessie Comprehensive Specialized Hospital, North-East Ethiopia

Abstract

Background The emergence of extended spectrum beta lactamase and carbapenemase production of Acinetobacter and Pseudomonas aeruginosa is a great concern and major cause of nosocomial infections due to its ability to production of extended spectrum beta lactamase and carbapenemase enzymes. Objective To assess Emergence of high prevalence of extended-spectrum beta-lactamase and Carbapenemase producing Acinetobacter species and Pseudomonas aeruginosa among hospitalized patients at Dessie Comprehensive Specialized Hospital, North-East Ethiopia. Materials and Methods A hospital-based cross-sectional study was conducted from February–August 2021 at Dessie Referral Hospital in the North eastern Ethiopia. A total of 423 clinical samples taken from admitted patients. Clinical specimens were collected aseptically and inoculated on blood agar and MacConkey agar media. Antimicrobial susceptibility test, ESBL and carbapenemase production were performed as CLSI guideline. The data were entered into the Epi-data and imported to Statistical Package for Social Science version 25. P value of <0.05 with odds ratio and 95% confidence interval was considered as statistically significant. Results Out of 423 clinical specimens 17.7% (75/423) were culture positive nosocomial infection. The proportions of nosocomial infection were higher in blood stream followed by wound infection which accounted 24.6%, 20.8%, respectively. Overall, 32/75 (42.7%) and 19/75 (25.3%) patients had infection with ESBL and CP producing bacterial infection. P. aeruginosa was the most predominant isolated bacteria 46/75 (52.9%). The overall multidrug resistance rate of the isolated bacteria was 88% (66/75). The majority of highest resistance rate was Piperacillin tazobactam 50 (66.7%) and Aztreonam 26 (56.5%), respectively, while least resistance rate was Amikacin 27 (36%). Conclusion The incidence rates of ESBL, carbapenemase production and antimicrobial resistant Acinetobacter species and P. aeruginosa infections are high. Therefore, treatment should be based on culture and antimicrobial test result and minimize the use of antibiotics empirically.

Prevalence and Trends of Carbapenem-Resistant Pseudomonas aeruginosa and Acinetobacter Species Isolated from Clinical Specimens at the Ethiopian Public Health Institute, Addis Ababa, Ethiopia: A Retrospective Analysis

“…In this retrospective study, we analyzed the five-year antimicrobial resistance profiles of P. aeruginosa and Acinetobacter species with an emphasis on the prevalence and trends of carbapenem resistance at the Ethiopian Public Health Institute, Addis Ababa, Ethiopia. The prevalence of carbapenem-resistant Acinetobacter species in the current study was 61%, which is consistent with the findings of the study from Pretoria, South Africa (63%), 27 and Jimma, Ethiopia (56.4%), 25 however, it is higher than the findings of studies from Lusaka, Zambia (18.2%), 28 Switzerland (9.2%), 29 North-East, Ethiopia (34.5%), 18 Sidama, Ethiopia (9.9%), 22 North Gondar, Ethiopia (20.77%), 24 Northwest Ethiopia (33.3%), 17 and Dessie, Ethiopia (43.8). 16 The variation could be attributed to differences in study design, the number of isolates analyzed, the types of specimens considered, and the amount of data analyzed, as some studies only analyzed fewer data, while others analyzed a large amount of national antimicrobial resistance data, geographical differences, and antibiotic prescription policy differences.…”

“…Infection and Drug Resistance 2023:16 1388 (12.9%) Table 3. Our findings are in line with the findings of studies from Ethiopia; Sidama, Ethiopia, 22 and Northeast Ethiopia 16,18 which reported higher resistance to cephalosporins (ceftazidime and cefepime) and lower resistance to aminoglycosides (amikacin, gentamicin, and tobramycin). The high prevalence of extended-spectrum cephalosporin resistance observed against these organisms could be attributed to the overprescription of these antibiotics in Ethiopia, even for minor infections.…”

“…During the study period, Acinetobacter species demonstrated the highest resistance to piperacillin/tazobactam (85.5%), extended-spectrum cephalosporins (ceftazidime 94.6%, ceftriaxone 94.1%, and cefepime 90%) and lowest resistance to aminoglycosides (amikacin 31.5%, and tobramycin 51.7%) and carbapenems (imipenem 59%) Table 2. Although the prevalence of resistance is higher in our study, the result is partially in agreement with studies from Sidama, Ethiopia, 22 and Northeast Ethiopia, 16,18 which reported the highest resistance to extended-spectrum cephalosporins and piperacillin/ tazobactam and lowest resistance to aminoglycosides and carbapenems.…”

“…In this study, the overall prevalence of carbapenem-resistant P. aeruginosa was 22%, which is lower compared to the study from Dessie Comprehensive Specialized Hospital, Ethiopia (41.3%), 18 Jimma, Ethiopia (30%), 25 and Felegehiwot referral hospital, Ethiopia (45.5%). 17 The observed variation could be attributed to the fact that they only analyzed 46, 10, and 11 P. aeruginosa isolates, respectively, and additionally the differences in study design since these studies used specimens collected from single health facilities.…”

Estudio piloto de caracterización microbiológica de los billetes que circulan en la ciudad de Bucaramanga, Colombia

“…Seas et al(22) confirma que la cepa Staphylococcus aureus se encuentra distribuida en gran parte de América Latina. Así como el género Staphylococcus es de gran inquietud, el género Acinetobacter también; es el principal causante de infecciones nosocomiales, se asocia con varias epidemias y altas tasas de mortalidad y específicamente, Acinetobacter baumanii es resistente a múltiples antibióticos(23).…”