Epidemiology and prevention of hospital-acquired carbapenem-resistant Enterobacterales infection in hospitalized patients, Northeast Ethiopia

Shibabaw, Agumas; Sahle, Zenawork; Metaferia, Yeshi; Atlaw, Asgdew; Adenew, Behailu; Gedefie, Alemu; Tilahun, Mihret; Ebrahim, Endris; Kassa, Yeshimebet; Debash, Habtu; Wang, Shuhua

doi:10.1016/j.ijregi.2023.02.008

Cited by 4 publications

(4 citation statements)

References 27 publications

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“…62 Recent data showed an increased detection of carbapenemase-producing Gram negative bacteria from clinical isolates in Ethiopia. 63,64 A systematic review and meta-analysis showed 5.4% pooled prevalence of carbapenemase-producing Enterobacterales, with high prevalence in Central Ethiopia. 65 Recent data reports bla KPC , bla NDM , and bla OXA-48 from clinical isolates of Enterobacterales in Ethiopia.…”

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confidence: 99%

Distribution of ß-Lactamase Genes Among Multidrug-Resistant and Extended-Spectrum ß-Lactamase-Producing Diarrheagenic Escherichia coli from Under-Five Children in Ethiopia

Zenebe,

Eguale,

Desalegn

et al. 2023

IDR

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Escherichia coli strains that produce extended-spectrum ß-lactamase (ESBL) and carbapenemase are among the major threats to global health. The objective of the present study was to determine the distribution of ß-lactamase genes among multidrugresistant (MDR) and ESBL-producing Diarrheagenic E. coli (DEC) pathotypes isolated from under-five children in Ethiopia. Patients and Methods:A cross-sectional study was conducted in Addis Ababa and Debre Berhan, Ethiopia. It was a health-facilitybased study and conducted between December 2020 and August 2021. A total of 476 under-five children participated in the study. DEC pathotypes were detected by conventional Polymerase Chain Reaction (PCR) assay. After evaluating the antimicrobial susceptibility profile of the DEC strains by disk diffusion method, confirmation test was done for ESBL and carbapenemase production. ßlactamase encoding genes were identified from phenotypically ESBLs and carbapenemase positive DEC strains using PCR assay. Results: In total, 183 DEC pathotypes were isolated from the 476 under-five children. Seventy-nine (43%, 79/183) MDR-DEC pathotypes were identified. MDR was common among enteroaggregative E. coli (EAEC) (58%, 44/76), followed by enterotoxigenic E. coli (ETEC) (44%, 17/39)) and enteroinvasive E. coli (EIEC) (30%, 7/23). Phenotypically, a total of 30 MDR-DEC pathotypes (16.4%, 30/183) were tested positive for ESBLs. Few ETEC (5.1%, 2/39) and EAEC (2.6%, 2/76) were carbapenemase producers. The predominant β-lactamase genes identified was bla TEM (80%, 24/30) followed by bla CTX-M (73%, 22/30), bla SHV (60%, 18/30), bla NDM (13%, 4/30), and bla OXA-48 (13%, 4/30). Majority of the ß-lactamase encoding genes were detected in EAEC (50%) and ETEC (20%). Co-existence of different β-lactamase genes was found in the present study. Conclusion:The bla TEM , bla CTX-M , bla SHV , bla NDM , and bla OXA-48 , that are associated with serious and urgent threats globally, were detected in diarrheagenic E. coli isolates from under-five children in Ethiopia. This study also revealed the coexistence of the βlactamase genes.

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confidence: 99%

Distribution of ß-Lactamase Genes Among Multidrug-Resistant and Extended-Spectrum ß-Lactamase-Producing Diarrheagenic Escherichia coli from Under-Five Children in Ethiopia

Zenebe,

Eguale,

Desalegn

et al. 2023

IDR

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“…Several bacterial pathogens are difficult to overcome, while it has been related with HAI infections. With the most prevalent HAIs episodes being caused by Acinetobacter baumannii [71], a group of Gram-negative nonfermenting betaproteobacteria called Burkholderia cepacia complex (Bcc) [72], Pseudomonas aeruginosa, a gram-negative bacillus that is ubiquitous and abundant in the environment, especially in moist condition [73], Clostridium difficile that can cause severe diarrhea [74], extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli [75], Carbapenemase-producing carbapenemresistant Enterobacterales (CP-CRE) [76], vancomycin-resistant Enterococci (VRE) that commonly reported causing the outbreak in surgical ICU ward [77], methicillin-resistant S. aureus (MRSA) [78], vancomycin-intermediate S. aureus (VISA) [79], and vancomycin-resistant S. aureus (VRSA) [79,80] with their increasing prevalence (both VISA and VRSA infections) is truly a cause of global concern. Finally Mycobacterium tuberculosis, [81] a causative agent responsible for numerous outbreaks of nosocomial tuberculosis due to its multidrugresistant strains.…”

Section: Some Important Mdr Hospital Acquired Infection's Agents: Foc...mentioning

confidence: 99%

Hospital Acquired Infection Revisited: Route of Transmission

Sunarti

2024

IJPR

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Aims: to revisited hospital route of infection transmission in patients under medical care with its related problems and re-focus on some important MDR nosocomial infection agents route of transmission to vulnerable patients. Discussion: Accidental infections acquired in hospitals or hospital acquired infection (HAI) is a global major health condition, and become a major obstacle in the present day era of hospitalization. Increased risk of morbidity with mortality, lengthened hospitalization, massive prescription of antibiotics, and socio-economically become a definite financial burden. Disinfection and sterilization in hospitals is of increasing concern. Besides that, the abuse of antibiotics has led to the prompt wide spread of multidrug-resistant drugs (MDR) microorganisms which is characterized by the ability to quickly adapt to an environment that previously does not support its growth commonly and able to initiate serious life-threatening HAI. The need to understand route of transmission and its associated obstacles will help combating MDR microorganisms. Conclusion: The Global emergence of MDR microorganisms with its difficult route of infections has created a major obstacle to combat the bacterial pathogens, and need serious attention from all stakeholders, throughout the world.

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“…According to various reports, antimicrobial resistance (AMR) poses a serious threat to public health everywhere, 12 including in Ethiopia with different AMR reports among humans and animal products 11,13,14 . Human can contract resistant bacteria from a variety of sources such as food products, the environment, and food handlers.…”

Section: Introductionmentioning

confidence: 99%

“…11 According to various reports, antimicrobial resistance (AMR) poses a serious threat to public health everywhere, 12 including in Ethiopia with different AMR reports among humans and animal products. 11,13,14 Human can contract resistant bacteria from a variety of sources such as food products, the environment, and food handlers. A significant issue in developing countries is the emergence and spread of antibiotic-resistant bacteria, which can be easily contracted as a result of substandard living conditions and limited access to medical care.…”

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confidence: 99%

Bacterial foodborne illness and Escherichia coli O157:H7 strain infection among asymptomatic food handlers in Northeast Ethiopia: Implication for hygienic practices and mass‐screening

Adefrash,

Sharew,

Amare

et al. 2024

Health Science Reports

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Background and AimsFood‐borne illness is a public health concern in developing countries because of improper food handling and sanitation practices, irregular medical checkups, lack of clean water supplies, and inadequate education among food handlers. This study investigated the burden of bacterial food‐borne illness, antibiotic resistance patterns, and associated factors among food handlers in prison and nonprison food establishment settings.MethodsA cross‐sectional study was conducted from August 2022 to January 2023 among asymptomatic food handlers in Shewa Robit town. A total of 384 food handlers participated. Data were collected using structured questionnaires. Stool and hand swab samples were collected and cultivated onto MacConkey agar, xylose‐lysine‐deoxycholate, Mannitol salt agar, and blood agar, and incubated at 37°C. Bacterial species were identified using biochemical tests and gram staining. Mueller–Hinton agar was used in Kirby Bauer's disk diffusion method. Data were entered and analyzed using SPSS. Descriptive and logistic regression analysis were performed.ResultsFecal and hand carriage rate of bacterial isolates were 106 (27.6%), and 214 (55.7%), respectively. Out of the 102 bacterial isolates, the most common ones from stool samples were Escherichia coli 71 (18.5%), Klebsiella aerogenes 12 (3.1%), and Salmonella spp. 7 (1.8%). Among 214 bacterial isolates, coagulase‐negative Staphylococci 115 (29.9%) and Staphylococci aureus 66 (17.3%) were identified from hand swab samples. Hand washing practice after restroom with water (adjusted odds ratio [AOR] = 2; 95% confidence interval [CI]: 1.16–3.45), irregular medical checkups (AOR = 2.49; 95% CI: 1.35–4.59), and did not receive food safety and hygiene training (AOR = 2.33; 95% CI: 1.34–4.05) were statistically significant association with food‐borne illness.ConclusionsFoodborne pathogens pose a serious health risk in the study areas. The level of antimicrobial resistance are also concerning. Food handlers should therefore get strict regular health education, medical checkups, and training programs to prevent the spread of infections to the customers.

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Epidemiology and prevention of hospital-acquired carbapenem-resistant Enterobacterales infection in hospitalized patients, Northeast Ethiopia

Cited by 4 publications

References 27 publications

Distribution of ß-Lactamase Genes Among Multidrug-Resistant and Extended-Spectrum ß-Lactamase-Producing Diarrheagenic Escherichia coli from Under-Five Children in Ethiopia

Distribution of ß-Lactamase Genes Among Multidrug-Resistant and Extended-Spectrum ß-Lactamase-Producing Diarrheagenic Escherichia coli from Under-Five Children in Ethiopia

Hospital Acquired Infection Revisited: Route of Transmission

Bacterial foodborne illness and Escherichia coli O157:H7 strain infection among asymptomatic food handlers in Northeast Ethiopia: Implication for hygienic practices and mass‐screening

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