Prevalence of Multidrug-Resistant &lt;/em&gt;Pseudomonas aeruginosa&lt;/em&gt; at Kenyatta National Hospital

Mukaya, Kilivwa J.S.; Njoroge, Samuel M.; Maina, John; Museve, Beatrice; Nyerere, Andrew; Kiiru, John

doi:10.19026/ajms.9.5857

Cited by 4 publications

(8 citation statements)

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“…From this study, the antimicrobial resistance patterns of the P. aeruginosa isolates to levofloxacin and meropenem were 31 and 30%, respectively. Although these levels are lower than the 61% of levofloxacin and 54% of meropenem resistance that were found in a study by Mukaya et al (2018) at Kenyatta National Hospital (a large referral hospital in Kenya), the high levels of piperacillin resistance in both studies (63 and 56.7%, respectively) suggests a reduced efficacy in the combination treatment for P. aeruginosa . Furthermore, the growing resistance patterns highlight the grave public health threat MDR P. aeruginosa poses.…”

Section: Discussioncontrasting

confidence: 66%

“…Further, antimicrobial resistance in P. aeruginosa is a present threat in Kenya. A 2018 study at Kenyatta National Hospital reported a 60% prevalence of MDR P. aeruginosa among critical care patients and a 35% prevalence among outpatients ( Mukaya et al, 2018 ), while a 2019 study by Wangai et al (2019) reported a 30% prevalence of carbapenem resistance in P. aeruginosa in a large public tertiary hospital in Kenya. Additionally, Musila et al (2021) found that of carbapenem-resistant P. aeruginosa isolates obtained from hospitals across Kenya, 13/14 were resistant to all antibiotics.…”

Section: Introductionmentioning

confidence: 99%

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Genetic Diversity, Distribution, and Genomic Characterization of Antibiotic Resistance and Virulence of Clinical Pseudomonas aeruginosa Strains in Kenya

et al. 2022

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Pseudomonas aeruginosa is a leading cause of nosocomial infections worldwide. It can produce a range of debilitating infections, have a propensity for developing antimicrobial resistance, and present with a variety of potent virulence factors. This study investigated the sequence types (ST), phenotypic antimicrobial susceptibility profiles, and resistance and virulence genes among clinical isolates from urinary tract and skin and soft tissue infections. Fifty-six P. aeruginosa clinical isolates were obtained from six medical centers across five counties in Kenya between 2015 and 2020. Whole-genome sequencing (WGS) was performed to conduct genomic characterization, sequence typing, and phylogenetic analysis of the isolates. Results showed the presence of globally distributed high-risk clones (ST244 and ST357), local high-risk clones (ST2025, ST455, and ST233), and a novel multidrug-resistant (MDR) clone carrying virulence genes (ST3674). Furthermore, 31% of the study isolates were found to be MDR with phenotypic resistance to a variety of antibiotics, including piperacillin (79%), ticarcillin-clavulanic acid (57%), meropenem (34%), levofloxacin (70%), and cefepime (32%). Several resistance genes were identified, including carbapenemases VIM-6 (ST1203) and NDM-1 (ST357), fluoroquinolone genes, crpP, and qnrVCi, while 14 and 22 different chromosomal mutations were detected in the gyrA and parC genes, respectively. All isolates contained at least three virulence genes. Among the virulence genes identified, phzB1 was the most abundant (50/56, 89%). About 21% (12/56) of the isolates had the exoU+/exoS- genotype, while 73% (41/56) of the isolates had the exoS+/exoU- genotype. This study also discovered 12 novel lineages of P. aeruginosa, of which one (ST3674) demonstrated both extensive antimicrobial resistance and the highest number of virulence genes (236/242, 98%). Although most high-risk clones were detected in Nairobi County, high-risk and clones of interest were found throughout the country, indicating the local spread of global epidemic clones and the emergence of new strains. Thus, this study illustrates the urgent need for coordinated local, regional, and international antimicrobial resistance surveillance efforts.

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Section: Discussioncontrasting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Genetic Diversity, Distribution, and Genomic Characterization of Antibiotic Resistance and Virulence of Clinical Pseudomonas aeruginosa Strains in Kenya

et al. 2022

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“…These antibiotics are administered intramuscular or intravenous injections hence they are less abused. Gram negative Pseudomonas species was found to be resistant to most antimicrobial agents similar to what was observed in Kenyatta National Hospital, Kenya (39). The high developed antimicrobial resistance in Pseudomonas species could be attributed to its mechanisms of mutation and secretion of enzymes that inactivates the antibiotics (39).…”

Section: Discussionsupporting

confidence: 54%

“…Susceptibility test showed that the bacteria isolates were resistant to amoxicillin and ampicillin. A study conducted in Kenya reported a prevalence of 72% to amoxicillin by Gram negative bacilli (39). The resistant of respiratory bacterial isolates to these antibiotics implies that these antibiotics are commonly used hence bacteria have developed resistance.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of bacterial respiratory infections and antimicrobial susceptibility profile among outpatients visiting Meru Teaching and Referral Hospital, Meru County, Kenya

Miriti

Muthini

Nyamache

2022

Preprint

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Objective:Respiratory tract infections cause significant morbidity and mortality globally and are the most common infectious diseases in humans. This study aimed at determining the prevalence of bacterial respiratory infections and antimicrobial susceptibility profile among outpatients presenting with respiratory tract infections in Meru teaching and referral hospital. Methods:The study was conducted in Meru teaching and referral hospital, Meru County from April 2017 to August 2018. A total of 175 sputum and throat samples were collected aseptically from patients who were clinically suspected to have respiratory infections and cultured in blood agar, MacConkey agar and chocolate agar. Bacterial isolates were identified by colonial morphology, Gram stain and confirmed by biochemical tests. Antimicrobial susceptibility profile was determined using agar disc diffusion method. Results: Respiratory bacterial pathogens were isolated in 43.6 % of the samples. The prevalence of the bacteria species isolated were as followsPseudomonas species (30.9 %), Staphylococcus aureus (22.2 %), Klebsiella species (19.8 %), Streptococcus pyogenes (14.8 %) and Streptococcus pneumoniae (12.4 %). The susceptibility test showed that both Gram positive and Gram-negativeisolates were highly susceptible to gentamicin, cefuroxime and amikacin while resistance was recorded for amoxicillin and ampicillin. However, resistance to more than two antibiotics was recorded in 54 (66.7 %) of the isolates. Conclusion: Many of the isolates obtained showed resistance to some antibiotics used hence there is need for a continuous surveillance of antimicrobial resistance in management of respiratory infections in Meru County. Ethical approval and consent to participate: This study obtained approval from Kenyatta University ethics review committee (KUERC) and ethics review committee of Meru teaching and referral hospital. Informed consent was obtained from all the subjects and their legal guardians. The patients voluntarily consented to participate in the study. All methods were carried out in accordance with relevant guidelines and regulations (declaration of helsinki). The ethics review committee of Meru teaching and referral hospital approved the study protocol.

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“…A study conducted in Kenya reported higher cases of bacterial acute respiratory infections in age groups 17–50 years [ 23 ]. Similarly, a related study in Nigeria reported more cases of lower respiratory tract infections among patients aged between 21 and 40 years [ 32 ]. Age group above 65 years had the least number of infections.…”

Section: Discussionmentioning

confidence: 92%

Study of bacterial respiratory infections and antimicrobial susceptibility profile among antibiotics naive outpatients visiting Meru teaching and referral hospital, Meru County, Kenya in 2018

2023

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Objective Respiratory tract infections cause significant morbidity and mortality globally and are the most common infectious diseases in humans. This study aims at assessing the presence of bacterial respiratory infections, number of people infected and antimicrobial susceptibility profile among antibiotic naïve outpatients presenting with respiratory tract infections in Meru Teaching and Referral Hospital. Methods The study was conducted in Meru Teaching and Referral Hospital, Meru County from April 2017 to August 2018. Upper respiratory infections were characterized by acute infection of nasal cavity, pharynx and larynx while lower respiratory infections were characterized by chest pains, prolonged cough, productive sputum, difficulty in breathing, fever and weight loss. A total of 384 sputum and throat samples were collected aseptically from patients who were clinically suspected to have respiratory infections and cultured in blood agar, MacConkey agar and chocolate agar. Bacterial isolates were identified by colonial morphology, Gram stain and confirmed by biochemical tests. Antimicrobial susceptibility profile was determined using agar disc diffusion method. Results Respiratory bacterial pathogens were isolated in 45.6% of the samples. The prevalence of the bacteria species isolated were as follows Pseudomonas species (36.6%), Klebsiella species (20.6%), Staphylococcus aureus (16.6%), Streptococcus pyogenes (13.7%), Streptococcus pneumoniae (10.3%) and mixed isolates (2.3%). Amoxicillin and ampicillin recorded the highest resistance rate. Most of the isolates displayed high level of resistance to more than two antibiotics. Although multidrug resistance is reported in the study, gentamicin, amikacin and cefuroxime are recommended as the antibiotics of choice against bacterial isolates obtained. Conclusion Bacterial respiratory infections were prevalent in the study area and the isolates obtained showed resistance to commonly used antibiotics such as amoxicillin, ampicillin, ciprofloxacin piperacillin ciprofloxacin, ceftazidime, piperacillin-tazobactam and cephalexin. Therefore need for a continuous surveillance of antimicrobial resistance in management of respiratory infections in the study area.

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Prevalence of Multidrug-Resistant </em>Pseudomonas aeruginosa</em> at Kenyatta National Hospital

Cited by 4 publications

References 0 publications

Genetic Diversity, Distribution, and Genomic Characterization of Antibiotic Resistance and Virulence of Clinical Pseudomonas aeruginosa Strains in Kenya

Genetic Diversity, Distribution, and Genomic Characterization of Antibiotic Resistance and Virulence of Clinical Pseudomonas aeruginosa Strains in Kenya

Prevalence of bacterial respiratory infections and antimicrobial susceptibility profile among outpatients visiting Meru Teaching and Referral Hospital, Meru County, Kenya

Study of bacterial respiratory infections and antimicrobial susceptibility profile among antibiotics naive outpatients visiting Meru teaching and referral hospital, Meru County, Kenya in 2018

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