Extended Spectrum Beta-lactamase producing E. coli and K. pneumoniae carriage among under five years children in Addis Raey public health center, Addis Ababa, Ethiopia.
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Date
2018-03
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Addis Ababa Universty
Abstract
Background: Extended-spectrum β-lactamase (ESBL) producing bacteria present an ever-growing burden in the hospital and community settings. Infections due to ESBL-containing pathogens continue to be associated with significant morbidity and mortality worldwide. Carriage of ESBL producing bacteria in the gut may serve as a reservoir of resistance genes that may subsequently be acquired by strains that cause clinically significant infection.
Objective: The objective of this study was to determine the prevalence of ESBL producing E. coli and K. pneumoniae carriage and associated factors among under five years children at Addis Raey public health center, Addis Ababa, Ethiopia.
Methods: A facility based cross sectional study was conducted from April to May 2017. Socio demographic and risk factors data were collected using questionnaires. Stool/rectal swab specimens collected from voluntary participants were inoculated on MacConkey agar. Bacteria identification, antimicrobial susceptibility testing and ESBL test were performed by VITEK 2 Compact (BioMe´rieux, France). Data was entered by EPI INFO version 7.2.1.0 and analyzed by SPSS version 20. The results were summarized and presented by tables.
Results: A total of 269 under five years children were recruited in the study. The mean and standard deviation of age were 22.48 and 15.83 months respectively. The overall prevalence of ESBL-producing Escherichia coli and Klebsella pneumoniae were 17.1% (46/269; 95% CI: 12.9%–22.7%). Of which, 83.0% were E. coli and 17.0% were K. pneumoniae. ESBL producing E. coli and K. pneumoniae isolates were showed high levels of MDR (93.6 %) and high rates of co-resistance to aminoglycosides, fluoroquinolones and trimethoprim-sulfamethoxazole. However, all ESBL producing isolates were susceptible to carbapenems (ertapenem and imipenem). Children of mother with lower educational level (primary school) (OR: 2.472, 95% CI: 1.323-4.618, P=0.0062) and children used tap water for drinking (OR: 1.714, 95% CI: 1.001-3.659, P=0.048) were factors significantly associated with higher ESBL carriage.
Conclusion: High prevalence of ESBL carriage in this study population was mainly Community-acquired and suggests a need for antimicrobial susceptibility surveillance and infection control measure.
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Keywords
Extended-spectrum β-lactamase, E. coli, K. pneumoniae, carriage, children.