Infection and Drug Resistance (May 2022)

High Magnitude of Fecal Carriage of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae at Debre Berhan Comprehensive Specialized Hospital, Ethiopia

  • Shenkute D,
  • Legese MH,
  • Yitayew B,
  • Mitiku A,
  • Engidaye G,
  • Gebremichael S,
  • Asrat D,
  • Woldeamanuel Y

Journal volume & issue
Vol. Volume 15
pp. 2445 – 2458

Abstract

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Demissew Shenkute,1 Melese Hailu Legese,2 Berhanu Yitayew,1 Asaye Mitiku,3 Getabalew Engidaye,4 Saba Gebremichael,5 Daniel Asrat,6 Yimtubezinash Woldeamanuel6 1Department of Medical Laboratory Science, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia; 2Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Medical Laboratory Science, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia; 4Department of Medical Laboratory Science, Debre Berhan Health Science College, Debre Berhan, Ethiopia; 5Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 6Department of Microbiology, Immunology, and Parasitology, College of Health Sciences Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Demissew Shenkute, Email [email protected]: Gastrointestinal colonization rate of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) is the major risk factor for infection and dissemination of resistance clones in healthcare facilities. This study aimed to investigate the magnitude of the fecal carriage of ESBL-PE and associated factors among hospitalized patients at Debre Berhan Comprehensive Specialized Hospital, North Shoa, Amhara Regional State, Ethiopia.Methods: A hospital-based cross-sectional study was conducted among 383 hospitalized patients from November 2020 to March 2021. Stool sample or rectal swab was aseptically collected and cultured on different culture media for isolation of Enterobacteriaceae. Identification was done by conventional biochemical tests. Screening of extended-spectrum beta-lactamase (ESBL) production was done by using cefotaxime and ceftazidime and confirmed by the combination disk method. Data analysis was performed by Statistical Package for Social Sciences software version 25 and a P-value ≤ 0.05 was considered as statistically significant.Results: From the total of 383 hospitalized patients, a total of 347 Enterobacteriaceae were isolated. The overall gastrointestinal colonization rate of ESBL-PE was 47.3% (164/347). The predominant ESBL-PE were E. coli 54.9% (90/164) and K. pneumoniae 33.5% (55/164). The overall multi-drug resistance rate (MDR) was 87.8% (305/347). The highest resistance was observed to ampicillin (98.3%), followed by gentamicin (80.7%), and tetracycline (73.3%), respectively. ESBL-PE were highly susceptible to meropenem (90.2%) and imipenem (89.0%). History of antibiotic use in the past 3 months (p< 0.001), admission in the neonatal intensive care unit (p=0.023), and presence of chronic disease (p< 0.001) were independently associated with fecal carriage of ESBL-PE.Conclusion: The magnitude of ESBL-PE and MDR was high in the study area. Meropenem and imipenem were active against ESBL-PE. Therefore, strict infection control measure is needed in the study area to limit the infection and dissemination of ESBL-PE.Keywords: fecal carriage, extended-spectrum beta-lactamase, Enterobacteriaceae, Ethiopia, hospitalized patients, associated factors

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