Exploration of risk factors for ceftriaxone resistance in invasive non-typhoidal Salmonella infections in western Kenya

Luvsansharav, Ulzii-Orshikh; Wakhungu, James; Grass, Julian; Oneko, Martina; Nguyen, Von; Bigogo, Godfrey; Ogola, Eric; Audi, Allan; Onyango, Dickens; Hamel, Mary J.; Mahon, Barbara E.

doi:10.1371/journal.pone.0229581

Cited by 7 publications

(4 citation statements)

References 23 publications

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“…Major outbreak of XDR salmonella has been observed in 2018 in Hyderabad [24]. In our study we have observed a striking increase in Ceftriaxone resistant XDR-salmonella isolates (29%) which is comparable to study conducted in Kenya [25]. Only treatment options left for such isolates are meropenem and azithromycin.…”

Section: Discussionsupporting

confidence: 80%

Bacterial Profile and Antibiogram of Microorganisms Isolated From Different Body Site Infections Among Patients of a Private Hospital, Karachi

Bakhat¹,

Nadeem²,

Taj³

et al. 2023

Pak J Pathol

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Objective:It is crucial to keep an eye on current patterns of multi-drug resistance and extensively drug resistance at local level to facilitate physicians in making justified decision regarding empirical therapy during this era of rising superbugs. Material and Methods: This antibiogram was made up according to CLSI (Clinical Laboratory Standard Institute) M100 guidelines. Samples were received for a period of 2-years from June 2019-June 2021 at National Medical Center Karachi. These samples were urine, blood, pus, cerebrospinal fluid (CSF), central venous pressure (CVP) tip, sputum and tracheal aspirates. Results: Out of 10564 samples received, 4582 were positive for growth of microorganisms. Sample distribution patterns according to the frequency of positive growth of isolates were predominantly urine (58%) and blood (17%) followed by pus (8%) and pus swab (6%) 2% fluid and 2% tracheal secretions, and 7% others like tips growth. Blood cultures were mainly received from Intensive care unit (50%) followed by out-patients departments (34%). The pattern of resistance observed in Escherichia coli (E. coli) revealed ampicillin as the most resistant among all antibiotics (93%) followed by cefixime (77%). Most sensitive antibiotic was amikacin (99%). The Staphylococcus aureus isolates were highly susceptible to vancomycin and linezolid (100%) followed by gentamicin (89%) and chloramphenicol (85%). Vancomycin resistance was observed in Enterococcus faecium (8%). Conclusion: Antimicrobial resistance among gram negative and gram-positive bacteria is increasing. This has left us with fewer therapeutic options which in turn highlights the issue of antimicrobial resistance being a global health concern. This emphasizes the significance of surveillance of antimicrobial patterns, development of antibiograms and implementation of antibiotic stewardship programs by judicious use of antibiotics for prevention of further spread of antimicrobial resistance. Key Words: Antibiogram, Antimicrobial resistance, Multidrug resistance, Extensively drug resistance

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Section: Discussionsupporting

confidence: 80%

Bacterial Profile and Antibiogram of Microorganisms Isolated From Different Body Site Infections Among Patients of a Private Hospital, Karachi

Bakhat¹,

Nadeem²,

Taj³

et al. 2023

Pak J Pathol

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“…These Typhimurium strains, with conferred ceftriaxone resistance, have been reported sporadically from Kenya, Malawi, and the Democratic Republic of the Congo. [56][57][58][59] Globally, Salmonella strains continue increasingly to acquire antimicrobial resistance, highlighting the urgent need for global AMR surveillance to inform antimicrobial treatment. MDR has been widespread in Asia and Africa since the 1990s.…”

Section: Discussionmentioning

confidence: 99%

Salmonella Bloodstream Infections in Hospitalized Children with Acute Febrile Illness—Uganda, 2016–2019

Appiah

Mpimbaza

Lamorde

et al. 2021

The American Journal of Tropical Medicine and Hygiene

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Invasive Salmonella infection is a common cause of acute febrile illness (AFI) among children in sub-Saharan Africa; however, diagnosing Salmonella bacteremia is challenging in settings without blood culture. The Uganda AFI surveillance system includes blood culture-based surveillance for etiologies of bloodstream infection (BSIs) in hospitalized febrile children in Uganda. We analyzed demographic, clinical, blood culture, and antimicrobial resistance data from hospitalized children at six sentinel AFI sites from July 2016 to January 2019. A total of 47,261 children were hospitalized. Median age was 2 years (interquartile range, 1–4) and 26,695 (57%) were male. Of 7,203 blood cultures, 242 (3%) yielded bacterial pathogens including Salmonella (N = 67, 28%), Staphylococcus aureus (N = 40, 17%), Escherichia spp. (N = 25, 10%), Enterococcus spp. (N = 18, 7%), and Klebsiella pneumoniae (N = 17, 7%). Children with BSIs had longer median length of hospitalization (5 days versus 4 days), and a higher case-fatality ratio (13% versus 2%) than children without BSI (all P < 0.001). Children with Salmonella BSIs did not differ significantly in length of hospitalization or mortality from children with BSI resulting from other organisms. Serotype and antimicrobial susceptibility results were available for 49 Salmonella isolates, including 35 (71%) non-typhoidal serotypes and 14 Salmonella serotype Typhi (Typhi). Among Typhi isolates, 10 (71%) were multi-drug resistant and 13 (93%) had decreased ciprofloxacin susceptibility. Salmonella strains, particularly non-typhoidal serotypes and drug-resistant Typhi, were the most common cause of BSI. These data can inform regional Salmonella surveillance in East Africa and guide empiric therapy and prevention in Uganda.

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“…infections. Ceftriaxone-resistant isolates have also been cultured from iNTS in the same region of Kenya, suggesting that these bacteria are circulating there and may become a significant public health threat in the future [ 43 ]. Resistance to ceftriaxone has emerged among NTS and is increasing in parts of South Asia, such as Pakistan, and controlling these infections will only become more difficult [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence ofSalmonellain Stool During the Vaccine Impact on Diarrhea in Africa (VIDA) Study, 2015–2018

Kasumba

Powell

Omore

et al. 2023

Clinical Infectious Diseases

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Background Non-typhoidal Salmonella (NTS) is a common cause of gastroenteritis in young children, with limited data on NTS serovars and antimicrobial resistance in Africa. Methods We determined the prevalence of Salmonella spp. and frequency of antimicrobial resistance among serovars identified in stools of 0–59 month-old children with moderate-to-severe diarrhea (MSD) and controls enrolled in the Vaccine Impact on Diarrhea in Africa (VIDA) Study in The Gambia, Mali, and Kenya in 2015–2018, and compared with data from the Global Enteric Multicenter Study (GEMS; 2007–2010) and the GEMS-1A study (2011). Salmonella spp. was detected by quantitative real-time PCR (qPCR) and culture-based methods. Identification of serovars was determined by microbiological methods. Results By qPCR, the prevalence of Salmonella spp. among MSD cases was 4.0%, 1.6%, and 1.9% and among controls was 4.6%, 2.4%, and 1.6% in The Gambia, Mali, and Kenya, respectively, during VIDA. We observed year-to-year variation in serovar distribution and variation between sites. In Kenya, Salmonella enterica serovar Typhimurium decreased (78.1% to 23.1%; P < .001) among cases and controls from 2007 to 2018, whereas serogroup O:8 increased (8.7% to 38.5%; P = .04). In The Gambia, serogroup O:7 decreased from 2007 to 2018 (36.3% to 0%; P = .001) but S. enterica serovar Enteritidis increased during VIDA (2015 to 2018; 5.9% to 50%; P = .002). Only 4 Salmonella spp. were isolated in Mali during all 3 studies. Multidrug resistance was 33.9% in Kenya and 0.8% in The Gambia across all 3 studies. Ceftriaxone resistance was only observed in Kenya (2.3%); NTS isolates were susceptible to ciprofloxacin at all sites. Conclusions Understanding variability in serovar distribution will be important for the future deployment of vaccines against salmonellosis in Africa.

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Exploration of risk factors for ceftriaxone resistance in invasive non-typhoidal Salmonella infections in western Kenya

Cited by 7 publications

References 23 publications

Bacterial Profile and Antibiogram of Microorganisms Isolated From Different Body Site Infections Among Patients of a Private Hospital, Karachi

Bacterial Profile and Antibiogram of Microorganisms Isolated From Different Body Site Infections Among Patients of a Private Hospital, Karachi

Salmonella Bloodstream Infections in Hospitalized Children with Acute Febrile Illness—Uganda, 2016–2019

Prevalence ofSalmonellain Stool During the Vaccine Impact on Diarrhea in Africa (VIDA) Study, 2015–2018

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