Klebsiella pneumonia in Sudan: Multidrug Resistance, Polyclonal Dissemination, and Virulence

Osman, Einas A.; Yokoyama, Maho; Altayb, Hisham N.; Cantillon, Daire; Wille, Julia; Seifert, Harald; Higgins, Paul G.; Al-Hassan, Leena

doi:10.3390/antibiotics12020233

Cited by 11 publications

(8 citation statements)

References 30 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In total, 35 were CR, and 3/35 were not CPE. However, the study indicated that among the total 86 sequenced strains, 37 were CPE, encoding for NDM-1, NDM-4, NDM-5, OXA-48 and OXA-232; 3 strains presented both NDM-5 and OXA-48 [137].…”

Section: Resultsmentioning

confidence: 94%

The Importance of Carbapenemase-Producing Enterobacterales in African Countries: Evolution and Current Burden

Chelaru,

Muntean,

Hogea

et al. 2024

Antibiotics

View full text Add to dashboard Cite

Antimicrobial resistance (AMR) is a worldwide healthcare problem. Multidrug-resistant organisms (MDROs) can spread quickly owing to their resistance mechanisms. Although colonized individuals are crucial for MDRO dissemination, colonizing microbes can lead to symptomatic infections in carriers. Carbapenemase-producing Enterobacterales (CPE) are among the most important MDROs involved in colonizations and infections with severe outcomes. This review aimed to track down the first reports of CPE in Africa, describe their dissemination throughout African countries and summarize the current status of CRE and CPE data, highlighting current knowledge and limitations of reported data. Two database queries were undertaken using Medical Subject Headings (MeSH), employing relevant keywords to identify articles that had as their topics beta-lactamases, carbapenemases and carbapenem resistance pertaining to Africa or African regions and countries. The first information on CPE could be traced back to the mid-2000s, but data for many African countries were established after 2015–2018. Information is presented chronologically for each country. Although no clear conclusions could be drawn for some countries, it was observed that CPE infections and colonizations are present in most African countries and that carbapenem-resistance levels are rising. The most common CPE involved are Klebsiella pneumoniae and Escherichia coli, and the most prevalent carbapenemases are NDM-type and OXA-48-type enzymes. Prophylactic measures, such as screening, are required to combat this phenomenon.

show abstract

Section: Resultsmentioning

confidence: 94%

The Importance of Carbapenemase-Producing Enterobacterales in African Countries: Evolution and Current Burden

Chelaru,

Muntean,

Hogea

et al. 2024

Antibiotics

View full text Add to dashboard Cite

show abstract

“…The results of this study are consistent with studies conducted in other LMICs (Ethiopia, 8 Zambia, 13 Peru 10 and Egypt 9 ), highlighting the poor link between different hospital wards and CMLs, lack of clinical specimens being sent for microbiological culture and susceptibility, and starting antibiotic treatment based on clinical findings, not being confirmed microbiologically (species and antibiogram). In a previous study, 14 we noted a surge in private laboratory diagnostic services that are replacing the hospital microbiology laboratories. Doctors are increasingly depending on outsourcing microbiological specimens, which results in poor and fragmented hospital data on burden and prevalence of bacteria and ABR.…”

Section: Discussionmentioning

confidence: 89%

Antibiotic resistance in Sudan: assessing the knowledge and practices of healthcare workers in Khartoum

Osman,

Omer,

Elmubarak

et al. 2024

JAC-Antimicrobial Resistance

Self Cite

View full text Add to dashboard Cite

Background Antibiotic resistance (ABR) is a major public health issue, associated with increased patient morbidity and mortality globally, with significantly higher rates in low- and middle-income countries (LMICs). Assessment of contextual factors, such as information, education, infrastructure and regulations are important for developing local solutions against ABR. Objectives To determine the knowledge and practices of healthcare workers (HCWs) towards ABR in hospitals in Sudan. Materials and methods A survey was conducted in three different hospitals in Khartoum, Sudan from February to December 2020. HCWs of different specialties and expertise were invited to participate. Data were descriptively analysed using Statistical Package for Social Sciences (SPSS). Results ABR was identified as a big challenge by 89% of 345 HCWs who participated. The results show that 79% of doctors don’t rely on the clinical microbiology laboratory (CML) results for antibiotic prescription or clinical decision-making. Sixty percent of HCWs agreed there are infection prevention and control (IPC) guidelines in their hospital, but 74% of them don’t have access to them, and infrequently receive relevant IPC training. Furthermore, HCWs obtain ABR information from other colleagues informally, not through local data or reports. Conclusions Despite adequate knowledge of ABR locally, there are significant contextual technical challenges facing HCWs in Sudan, such as availability of policies and accurate data from CMLs. The results indicate a poor link between HCWs and the CMLs for infection management and it is essential to improve communication between the different hospital departments with regard to ABR transmission, and ensure the effectiveness of local IPC policies based on locally available data.

show abstract

“…on cerebrospinal fluid; 36.6% of the isolates were MDR of which 69.2% were Gram-negatives and 30.8% were Gram-positives [ 20 ]. Additionally, in Sudan, 80% of K. pneumoniae were reported as MDR [ 21 ], and one more study found that there was a high prevalence of MDR Enterobacteriaceae ; mainly ESBL-positive E. coli and K. pneumoniae [ 22 ], Whereas 18% of P. aeruginosa isolates were MDR in a recent work published in 2023 [ 23 ], and 89.2% of S. aureus were MDR, of them 67.6% were methicillin resistant [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of multi-drug resistant bacteria in intensive care units at Tripoli University Hospital, Tripoli, Libya

Ibrahim,

Thwood,

ELgheriani

et al. 2024

Libyan Journal of Medicine

View full text Add to dashboard Cite

Among hospitalized patients worldwide, infections caused by multidrug-resistant (MDR) bacteria are a major cause of morbidity and mortality. This study aimed to isolate MDR bacteria from five intensive care units (ICUs) at Tripoli University Hospital (TUH). A prospective cross-sectional study was conducted over a seven-month period (September 2022 to March 2023) across five ICUs at TUH. A total of 197 swabs were collected from Patients’, healthcare workers’ and ICUs equipment. Samples collected from patients were nasal swabs, oral cavity swabs, hand swabs, sputum specimens, skin swabs, umbilical venous catheter swabs, and around cannula. Swabs collected from health care workers were nasal swabs, whereas ICUs equipment’s samples were from endotracheal tubes, oxygen masks, and neonatal incubators. Identification and antimicrobial susceptibility test was confirmed by using MicroScan auto SCAN 4 (Beckman Coulter). The most frequent strains were Gram negative bacilli 113 (57.4%) with the predominance of Acinetobacter baumannii 50/113 (44%) followed by Klebsiella pneumoniae 44/113 (40%) and Pseudomonas aeruginosa 6/113 (5.3%). The total Gram positive bacterial strains isolated were 84 (42.6%), coagulase negative Staphylococci 55 (66%) with MDRs (89%) were the most common isolates followed by Staphylococcus aureus 15 (17.8%). Different antibiotics were used against these isolates; Gram- negative isolates showed high resistance rates to ceftazidime, gentamicin, amikacin and ertapenem. A. baumannii were the most frequent MDROs (94%), and the highest resistance rates in Gram-positive strains were observed toward ampicillin, oxacillin, ampicillin/sulbactam and Cefoxitin, representing 90% of total MDR Gram-positive isolates. ESBL and MRS were identified in most of strains. The prevalence of antibiotic resistance was high for both Gram negative and Gram positive isolates. This prevalence requires strict infection prevention and control intervention, continuous monitoring, implementation of effective antibiotic stewardship, immediate, concerted and collaborative action to monitor its prevalence and spread in the hospital.

show abstract

Klebsiella pneumonia in Sudan: Multidrug Resistance, Polyclonal Dissemination, and Virulence

Cited by 11 publications

References 30 publications

The Importance of Carbapenemase-Producing Enterobacterales in African Countries: Evolution and Current Burden

The Importance of Carbapenemase-Producing Enterobacterales in African Countries: Evolution and Current Burden

Antibiotic resistance in Sudan: assessing the knowledge and practices of healthcare workers in Khartoum

Prevalence of multi-drug resistant bacteria in intensive care units at Tripoli University Hospital, Tripoli, Libya

Contact Info

Product

Resources

About