P075: Emergence of carbapenem-resistant enterobacteriaceae in surgical and intensive care units of a hospital with low usage of carbapenem in Kano, North West Nigeria

Ibrahim, Yusuf; Arzai, AH; Getso, Muhammad Ibrahim; Sherif, Aida; Haruna, Musa

doi:10.1186/2047-2994-2-s1-p75

Cited by 7 publications

(7 citation statements)

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“…Following preliminary screening with meropenem and ertapenem, a resistance of 22 (9.7%) and 28 (12.4%) were reported respectively. This was similar to a prevalence reported by Yusuf et al in Kano among isolates of Enterobacteriaceae to imipenem and meropenem of 10.5% and 12.5% respectively following phenotypic screening from surgical and intensive care units [13]. The same author reported a 7.4% resistance to imipenem and 87.5% resistance to meropenem among Enterobacteriaceae using the same study design from the same institution but in a different patient population [14].…”

Section: Discussionsupporting

confidence: 73%

Characterization of KPC, NDM and VIM Type Carbapenem Resistance <i>Enterobacteriaceae</i> from North Eastern, Nigeria

Mohammed¹,

Zailani²,

Onipede³

2015

JBM

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Introduction and Aim: Carbapenem resistance among species of Enterobacteriaceae has emerged as a global public health problem that adds to the high cost of care, severity and high mortality of otherwise straightforward infections. Governments around the world are devoting efforts to combat this important threat. The present study was undertaken in our setting to detect and characterize carbapenem resistance among Enterobacteriaceae. Methodology: Confirmed species of Enterobacteriaceae isolated from 225 patients that were admitted in various units of University of Maiduguri Teaching Hospital (UMTH) Maiduguri were screened for carbapenem resistance with meropenem and ertapenem disc (10 µg, Oxoid, England) using clinical and laboratory standards institute (CLSI) breakpoints. Suspected carbapenemase producers were subjected to confirmation using Modified Hodge Test method. Detection of the carbapenemase genes was done by multiplex PCR using KPC, NDM-1 and VIM primers. Results: A total of 225 clinical isolates of Enterobacteriaceae comprising 73 (32.4%) of Klebsiella pneumoniae, 61 (27.1%) of Escherichia coli, 21 (9.3%) of Proteus mirabilis, 18 (8.0%) of Klebsiella oxytoca, 13 (5.8%) of Morganella morganii, 12 (5.3%) of Citrobacter freundii, 12 (5.3%) of Serratia marcescens, 7 (3.1) of Enterobacter aerogenes, 3 (1.4%) of Klebsiella ozaenae, 3 (1.4%) of Hafnia alvei and 2 (0.9%) of Citrobcter sedlakii were isolated. A total of 28 (12.4%) of the isolates screened positive as carbapenemase producers. All the 28 screened isolates were further subjected to confirmation using the Modified Hodge Test for which 23 (10.2%) were confirmed resistant. Therefore a prevalence of 10.2% for carbapenem resistance was recorded in this study. Based on multiplex polymerase chain reaction, the various percentage genotypes of the carbapenemase producers were: 11 (47.8%) for KPC, 2 (8.7%) for VIM while 5 (21.7%) isolates have co-existence of the NDM-1 and VIM genes. However, 5 (21.7%) of the iso- 101lates have none of the genes screened for in them. The occurrence of carbapenemase genes among species of Enterobacteriaceae was as follows: 6 (33.3%) for Klebsiella pneumoniae, 4 (22.2%) for Escherichia coli, 4 (22.2%) for Proteus mirabilis, 3 (16.7%) for Serratia marcescens and then 1 (5.6%) for Klebsiella oxytoca. Conclusion: Despite the low use of carbapenem agents in the study area, carbapenem resistance was documented. This calls for an ongoing surveillance and infection control practices of this and other emerging resistance threat in all health centers of Nigeria. Irrational use of antibiotics must be discouraged so as to reduce this resistance threat. Antibiotic stewardship program should be established in all tertiary health centers of Nigeria.

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Section: Discussionsupporting

confidence: 73%

Characterization of KPC, NDM and VIM Type Carbapenem Resistance <i>Enterobacteriaceae</i> from North Eastern, Nigeria

Mohammed¹,

Zailani²,

Onipede³

2015

JBM

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“…The occurrence rate of KPC producing Klebsiella pneumoniae observed in this study (0.0%) is lower than a prevalence of (29.9%) reported by [31] among patients in intensive care unit and surgical wards of tertiary health care centers in Kano. The reason for the higher prevalence in their study is because they were dealing with hospitalized patients who form one of the populations at risk of habouring KPC organisms.…”

Section: Klebsiella Pneumoniae To the Antibiotics Tested As Determined Bauer Disc Diffusion Technique According To Clsi Cut Pointscontrasting

confidence: 79%

“…Emergence and spread of carbapenemases account for the resistance of bacteria to carbapenems which were the "drug of last resort" in the treatment of infection caused by multidrug resistant Gram negative bacteria. The only treatment option that remains potentially toxic to carbapenems resistant bacteria is polymyxin B and colistin [30] and Tigecycline [31]. Due to increase and spread of carbapenems resistant bacteria, in a 2013 Threat Report on Antimi crobial Resistance, the CDC prioritized CRE as an urgent threat (the highest level), requiring concerted commitment and action, and noted that ≈50% of hospitalized pa bloodstream infection caused by CRE die from the infection [32,33].…”

Section: Ssionmentioning

confidence: 99%

“…A moderately high and high resistance to Tetracycline (57.9%) and Cotrimoxazole (78.9%) respectively were Emergence and spread of carbapenemases account for the resistance of bacteria to ug of last resort" in the treatment of infection caused by multidrug resistant Gram negative bacteria. The only treatment option that remains potentially toxic to carbapenems resistant bacteria is polymyxin B and colistin [30] and Tigecycline [31] Antibiotic resistance has no border to cross especially in setting where proper infection control is not in practice. It doesn't discriminate between the specimen from which the organism was isolated or even the gender and age of the patient from which it was isolated as demonstrated by the isolates screened in study.…”

Section: Ssionmentioning

confidence: 99%

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Occurrence of Carbapenem Resistant Klebsiella pneumoniae in Clinical Samples from Some Selected Hospitals in Zaria, Kaduna State

Hussaini

Olonitola

Suleiman

2017

JAMPS

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Aims:The aim of the study was to determine the occurrence of carbapenem resistant Klebsiella pneumoniae in clinical samples from some selected hospitals in Zaria, Kaduna state. Study Design: Hospital based cross sectional study. The study was carried out over a period of 6 months from June to November 2015. Methodology: A total of 150 clinical samples were collected from which 19 Klebsiella pneumoniae were isolated. Antibiotic susceptibility testing was carried out for all the isolates. The isolate that was resistant to Imipenem was screened for K. pneumoniae carbapenase production using the Modified Hodge Test. Results: Out of the 19 isolates screened, only one was intermediately resistant to Imipenem. This isolate was screened for Klebsiella pneumoniae carbapenemase (KPC) production using the Modified Hodge Test (Cloverleaf test). The isolate was a non KPC producer, suggesting the Short Communication

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“…This study shows 7.9% prevalence for meropenem and imipenem respectively. This is lower to the prevalence rate of 9.7% (meropenem) and 12.4% (ertapenem) reported by Yahaya et al [10] in Maiduguri, North-Eastern Nigeria and 10.5% (imipenem) and 12.5% (meropenem) documented by Yusuf et al [11] in Kano among isolates of Enterobacteriaceae. Similarly, Rawan et al [12] and Deogratius et al [13] also observed a higher prevalence of 12.1% and 22.4% in Gaza strip, Palestine and Sudan.…”

Section: Discussioncontrasting

confidence: 69%

Prevalence of Carbapenem-Resistance among Enterobacteriaceae Isolated from Patients Attending Uduth Sokoto, North West Nigeria

Iduh

Mohammed

Garba

et al. 2020

IJTDH

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The major problem threatening the continued success of antimicrobial drugs is the development of resistant organisms. This study was designed to determine the occurrence and prevalence of carbapenem resistance among enterobacteriaceae isolated from in-patients attending Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, and also to determine the antimicrobial susceptibility patterns of the organisms isolated. The Methodology involves the use of trypticase soy broth containing 10 μg of carbapenem (imipenem) for primary isolation. The secondary isolation involves the use of MacConkey agar and biochemical (Simmon citrate Agar) for identification, and then antimicrobial susceptibility testing by the disk diffusion method. A total of 191 stool samples from male and female in-patients within the range of 2-60 years were screened for the gastrointestinal colonization of Carbapenem Resistance Enterobacteriacea (CRE). Data were analysed using Statistical Package for Social Sciences (SPSS) windows version 21. The overall prevalence was 15.7% The prevalence rate was found exclusively in males. The highest prevalence was found within the age group of 30-40 years. Escherichia coli, Klebsiella species, Pseudomonas species and salmonella species were the bacteria isolated. The most predominant bacteria isolated were Escherichia coli, accounting for 85 (9.4%) resistant strains, Klebsiella species accounting for 50 (8%) resistant strain, Pseudomonas aeruginosa 21% and Salmonella species accounting for 42 (0%) no resistant strain isolated. The misuse of antibiotics is a major factor responsible for the high rate of bacterial resistance. Improvement on the management and personal hygiene, as well as the appropriate use of antibiotics would reduce the prevalence of Nosocomial Carbapenem Resistance (NCR) especially among prolonged hospitalized patients.

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P075: Emergence of carbapenem-resistant enterobacteriaceae in surgical and intensive care units of a hospital with low usage of carbapenem in Kano, North West Nigeria

Cited by 7 publications

References 1 publication

Characterization of KPC, NDM and VIM Type Carbapenem Resistance <i>Enterobacteriaceae</i> from North Eastern, Nigeria

Characterization of KPC, NDM and VIM Type Carbapenem Resistance <i>Enterobacteriaceae</i> from North Eastern, Nigeria

Occurrence of Carbapenem Resistant Klebsiella pneumoniae in Clinical Samples from Some Selected Hospitals in Zaria, Kaduna State

Prevalence of Carbapenem-Resistance among Enterobacteriaceae Isolated from Patients Attending Uduth Sokoto, North West Nigeria

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P075: Emergence of carbapenem-resistant enterobacteriaceae in surgical and intensive care units of a hospital with low usage of carbapenem in Kano, North West Nigeria

Cited by 7 publications

References 1 publication

Characterization of KPC, NDM and VIM Type Carbapenem Resistance &lt;i&gt;Enterobacteriaceae&lt;/i&gt; from North Eastern, Nigeria

Characterization of KPC, NDM and VIM Type Carbapenem Resistance &lt;i&gt;Enterobacteriaceae&lt;/i&gt; from North Eastern, Nigeria

Occurrence of Carbapenem Resistant Klebsiella pneumoniae in Clinical Samples from Some Selected Hospitals in Zaria, Kaduna State

Prevalence of Carbapenem-Resistance among Enterobacteriaceae Isolated from Patients Attending Uduth Sokoto, North West Nigeria

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Characterization of KPC, NDM and VIM Type Carbapenem Resistance <i>Enterobacteriaceae</i> from North Eastern, Nigeria

Characterization of KPC, NDM and VIM Type Carbapenem Resistance <i>Enterobacteriaceae</i> from North Eastern, Nigeria