Infection and Drug Resistance (Nov 2023)

Distribution of ß-Lactamase Genes Among Multidrug-Resistant and Extended-Spectrum ß-Lactamase-Producing Diarrheagenic Escherichia coli from Under-Five Children in Ethiopia

  • Zenebe T,
  • Eguale T,
  • Desalegn Z,
  • Beshah D,
  • Gebre-Selassie S,
  • Mihret A,
  • Abebe T

Journal volume & issue
Vol. Volume 16
pp. 7041 – 7054

Abstract

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Tizazu Zenebe,1,2 Tadesse Eguale,3,4 Zelalem Desalegn,1 Daniel Beshah,5 Solomon Gebre-Selassie,1 Adane Mihret,1,6 Tamrat Abebe1 1Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia; 2Department of Medical Laboratory Science, Debre Berhan University, Debre Berhan, Ethiopia; 3Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia; 4Ohio State University, Global One Health LLC, Addis Ababa, Ethiopia; 5Department of Medical Laboratory, Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia; 6Bacterial and Viral Disease Research Directorate, Armauer Hansen Research Institute (AHRI), Addis Ababa, EthiopiaCorrespondence: Tizazu Zenebe, Department of Medical Laboratory Science, Debre Berhan University, P.O.Box 445, Debre Berhan, Ethiopia, Tel +251912372837, Email [email protected]: Escherichia coli strains that produce extended-spectrum ß-lactamase (ESBL) and carbapenemase are among the major threats to global health. The objective of the present study was to determine the distribution of ß-lactamase genes among multidrug-resistant (MDR) and ESBL-producing Diarrheagenic E. coli (DEC) pathotypes isolated from under-five children in Ethiopia.Patients and Methods: A cross-sectional study was conducted in Addis Ababa and Debre Berhan, Ethiopia. It was a health-facility-based study and conducted between December 2020 and August 2021. A total of 476 under-five children participated in the study. DEC pathotypes were detected by conventional Polymerase Chain Reaction (PCR) assay. After evaluating the antimicrobial susceptibility profile of the DEC strains by disk diffusion method, confirmation test was done for ESBL and carbapenemase production. ß-lactamase encoding genes were identified from phenotypically ESBLs and carbapenemase positive DEC strains using PCR assay.Results: In total, 183 DEC pathotypes were isolated from the 476 under-five children. Seventy-nine (43%, 79/183) MDR-DEC pathotypes were identified. MDR was common among enteroaggregative E. coli (EAEC) (58%, 44/76), followed by enterotoxigenic E. coli (ETEC) (44%, 17/39)) and enteroinvasive E. coli (EIEC) (30%, 7/23). Phenotypically, a total of 30 MDR-DEC pathotypes (16.4%, 30/183) were tested positive for ESBLs. Few ETEC (5.1%, 2/39) and EAEC (2.6%, 2/76) were carbapenemase producers. The predominant β-lactamase genes identified was blaTEM (80%, 24/30) followed by blaCTX-M (73%, 22/30), blaSHV (60%, 18/30), blaNDM (13%, 4/30), and blaOXA-48 (13%, 4/30). Majority of the ß-lactamase encoding genes were detected in EAEC (50%) and ETEC (20%). Co-existence of different β-lactamase genes was found in the present study.Conclusion: The blaTEM, blaCTX-M, blaSHV, blaNDM, and blaOXA-48, that are associated with serious and urgent threats globally, were detected in diarrheagenic E. coli isolates from under-five children in Ethiopia. This study also revealed the coexistence of the β-lactamase genes.Keywords: Diarrheagenic E. coil, under-five children, ß-lactamase, carbapenemase, ESBL, multidrug resistance, Ethiopia

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