Cancer Management and Research (Nov 2023)

Fecal Carriage of Extended-Spectrum β-Lactamase and Carbapenemase-Producing Enterobacteriaceae Among Oncology and Non-Oncology Patients at Jimma Medical Center in Ethiopia: A Comparative Cross-Sectional Study

  • Temsegen W,
  • Gorems K,
  • Mekonnen M,
  • Fufa D,
  • Kassa T

Journal volume & issue
Vol. Volume 15
pp. 1217 – 1231

Abstract

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Wubalech Temsegen,1,2 Kasahun Gorems,2,3 Mekidim Mekonnen,1 Diriba Fufa,4 Tesfaye Kassa1 1School of Medical Laboratory Science, Faculty of Health Sciences, Jimma University, Jimma, Ethiopia; 2Microbiology Diagnostic Laboratory Unit of Jimma Medical Center, Jimma, Ethiopia; 3Department of Microbiology, Immunology and Parsitology, St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia; 4Department of Pediatrics & Child Health, School of Medicine, Jimma University, Jimma, EthiopiaCorrespondence: Kasahun Gorems, Department of Microbiology, Immunology and Parsitology, St Paul’s Hospital Millennium Medical College, P. O. Box, 1271, Addis Ababa, Ethiopia, Tel +251925494531, Email [email protected]; [email protected] Tesfaye Kassa, School of Medical Laboratory Sciences, Jimma University, P. O. Box 788, Jimma, Ethiopia, Tel +251931057195, Email [email protected]; [email protected]: Extended-spectrum β-lactamase (ESBL) and carbapenemase-producing Enterobacteriaceae (CPE) are among the major threats to global health because of their encoded protection against key antibiotics.Methods: A comparative cross-sectional study was conducted among oncology and non-oncology patient groups (1:1; n = 214) on a consecutive sampling approach. Stool or rectal swab was collected from June 2021 to November 2021 and screened for ESBL-PE and CPE using ChromID-ESBL media. Confirmation for the enzymes was made by using combination disc and modified carbapenem inactivation methods, respectively. Disk diffusion method was used to determine antimicrobial susceptibility testing following the recommendations of CLSI 2022. SPSS software version 23 was used for data analysis.Results: Fecal carriage prevalence of ESBL-PE was found in 90 (84.1%) of oncology participants and in 77 (71.9%) of non-oncology patients (p = 0.032). Escherichia coli was the most common ESBL-PE isolate in 82 (62.5%) and 68 (88.3%) of oncology and non-oncology patients, followed by Klebsiella oxytoca [15 (11.5%) versus 6 (7.8%)], respectively. Out of the total ESBL-PE isolates from both oncology and non-oncology patient groups, the maximum level of resistance was observed against ciprofloxacin 177 (86.3%), trimethoprim-sulfamethoxazole 103 (80.3%), tetracycline 97 (75.8%), whereas enhanced susceptibility was appreciated to tigecycline 200 (97.6%), meropenem 162 (79.0%), and ertapenem 145 (70.7%) with no significant difference between oncology and non-oncology group. Carbapenemase-producing isolates from oncology patients were 12 (11.2%), whereas it was 4 (3.7%) (p = 0.611) from non-oncology group. Bacterial isolates from oncology in this study showed a trend of multiple drug resistance of 113 (88.3%).Conclusion: The results revealed alarmingly high carriage rates of ESBL and CPE among all study participants. Moreover, the isolates showed increased resistance rates to alternative drugs and had multiple antibiotic-resistant patterns. Hence, it is important to emphasize strict adherence to antimicrobial stewardship program as well as infection prevention and control practices.Keywords: carriage rate, oncology, extended-spectrum beta-lactamase, carbapenemase, Enterobacteriaceae, Ethiopia

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