Multi-Drug Resistant, Extended Spectrum beta-Lactamase and Carbapenemase Producing Bacterial Isolates among Septicemia Suspected under Five Children in Tikur Anbesa Specialized Hospital, Addis Ababa Ethiopia: Cross-sectional study

Abstract

Background: Bloodstream infections due to bacterial pathogens are a major cause of morbidity and mortality among pediatric patients. Emergence of drug resistance in high classes of antibiotics among the bacterial pathogens is another issue of the public health concern. Therefore this study aimed to determine Multi-drug resistant, extended spectrum β-lactamase and carbapenemase producing bacterial isolates among septicemia suspected under five Children in Tikur Anbesa Specialized Hospital, Addis Ababa Ethiopia. Methods: Across-sectional study was conducted from September 2017 to June 2018 among pediatric patients with febrile illness aged under five in Tikur Anbesa Specialized Hospital. Three hundred forty blood samples were collected and processed following standard microbiological techniques and culture was performed using BacT/Alert machine in combination with conventional method. AST of the isolates was performed by Kirby-Bauer disc diffusion method and MIC technique Result: A total of 137(40.2%) bacterial pathogens were isolated from 340 pediatric patients suspected of BSI with febrile illness. Of these isolates 54% were Gram negative bacteria. Of the isolates 43 (31.4%) Klebsiella pneumoniae and Acinitiobactor species were the most frequently isolated pathogens. Klebsiella pneumoniae isolates were 95.6% MDR, 23.7% ESBL, and 27.1% CRE in children. Conclusion: In this study, Klebsiella pneumoniae and S. aureus are common pathogens associated with BSI in pediatrics with high antimicrobial resistance. The prevalence of MDR 51.1%, CRE 30.5% and ESBL 25.4% were alarmingly high in bacterial isolates. ESBL producing organisms were common in Klebsiella species and Escherichia coli isolates. Since most of isolates exhibit multidrug resistant, invitro- susceptibility of antimicrobials is mandatory. Strengthen antimicrobial surveillance system and antimicrobial stewardship are necessary for better management of antibiotics in addition to infection prevention practice in TASH settings. Key words: Blood stream infection, BacT/Alert, multi-drug resistance, Extended spectrum beta-lactamase, Carbapenem resistance entrobacteriaciae.

Antimicrobial Resistance and Associated Risk Factors of Gram-Negative Bacterial Bloodstream Infections in Tikur Anbessa Specialized Hospital, Addis Ababa

“…The higher involvement of GNB 54.57%, than GPB 45.43%, in BSI, detected in the current study is similar to previous reports from Addis Ababa, Ethiopia, 19 , 45 and Bahir Dar, Ethiopia. 15 , 17 The difference could be due to the greater tendency of Gram-negative organisms in becoming a major drug-resistant cause of nosocomial infections.…”

“…The overall prevalence of culture-positive results in this study, 28.06%, was comparable with the study done in Mekelle, Ethiopia, 28%, 16 in Addis Ababa Ethiopia, 27.9%, 19 in Weldia, Ethiopia, 25.78%, 43 and Athens, Greece, 29%. 44 However, the current prevalence is lower than the study done in Addis Ababa, Ethiopia, 40.2%, 45 in Bahir Dar, Ethiopia, 39.2%, 17 and in Addis Ababa, Ethiopia, 32.8%. 36 On the other hand, the current finding is higher than the study done in Addis Ababa, Ethiopia, 20.8%, 15 Gonder, Ethiopia, 18.2%, 14 and Malawi 30%.…”

“…A study done on TASH shows a high rate (44.7%) of positive blood cultures (reported in NICU 19 , 57 and MICU). 45 Identification of bacteria in admission wards shows that K. pneumoniae has been identified abundantly from NICU, C/W, and MICU respectively. CoNS were identified from MICU, C/W, and EOPD.…”

Multi-Drug Resistance Profile, Prevalence of Extended-Spectrum Beta-Lactamase and Carbapenemase-Producing Gram Negative Bacilli Among Admitted Patients After Surgery with Suspected of Surgical Site Nosocomial Infection North East Ethiopia

“…However, the prevalence of Gram-negative bacteria among surgical site infections was 52.9% (203/384). It is in line with a study conducted in Addis Ababa, 54% 29 and Nigeria (50.9%). 30 However, the present study presented that higher than study done in Bahir Dar Ethiopia 35.2%, 31 in Ethiopia (25.13%), 32 Uganda (32%) 33 and India (37%), 34 Mexico (19%), 35 Nipa (19.5%) 36 and Nepal (12.6%).…”

Bacterial Profile among Patients with Suspected Bloodstream Infections in Ethiopia: A Systematic Review and Meta-Analysis

“…As illustrated in Table 1 , all the included studies in the final quantitative analysis were observational, 20 were cross-sectional [ 7 , 14 , 16 , 35 , 36 , 38 , 39 , 42 – 47 , 49 – 53 , 55 ] and 6 were retrospective [ 11 , 16 , 40 , 41 , 48 , 52 ] by study design. The included studies were conducted in four regions (Amhara, Tigray, Oromia, and Southern Nations, Nationalities, and Peoples' Region (SNNPR)) and from the two self-administrative cities (Addis Ababa and Dire Dawa).…”