Multidrug resistance among fermentative and non-fermentative gram-negative bacilli isolated from clinical specimens at Arsho Advanced Medical Laboratory, Addis Ababa, Ethiopia
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Date
2019-10
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Addis Ababa University
Abstract
Background: Antimicrobial resistance has recently been identified as one of the three most important problems facing human health by the World Health Organization. Gram negative bacteria are major producers of extended-spectrum beta-lactamase and carbapenemase enzymes which made them multidrug resistant.
Objective: This study aimed to determine magnitude of multidrug resistant fermentative and non-fermentative gram-negative bacilli isolated from clinical specimens at Arsho Advanced Medical Laboratory, Addis Ababa, Ethiopia.
Methods: A cross-sectional study was conducted from January 1 to March 30, 2019. A total of 873 different clinical samples were collected and inoculated to MacConkey agar, Blood Agar and Chocolate agar. Species identification, antimicrobial susceptibility testing and extended spectrum beta-lactamase screening was performed using VITEKĀ®2 automation. Extended spectrum beta-lactamase production was confirmed with combined disc method. Carbapenem resistance was performed on Muller Hinton agar and carbapenemase producers were confirmed by modified carbapenem inactivation method as per Clinical and Laboratory Standards Institute guideline. Data was entered and analyzed using SPSS version 23.
Results: From 873 various clinical samples processed, 175 gram negative bacteria were isolated of which 88% (154/175) were fermenters and 12% (21/175) were non-fermenters. Majority of the isolates were from urine (56%) followed by wound (21.7%) specimen. The predominant isolates were Escherichia coli, 58.3% (102/175) from fermenters and Pseudomonas aeruginosa, 5.1% (9/175) from non-fermenters. Highest resistance level was seen in ampicillin (86%) and cefalotin (73.2%), and lowest resistance against meropenem (9.8%) and tobramycin (18.9%). Overall Multidrug resistance was 80.5%, extended spectrum beta-lactamase production was 28% and carbapenemase production was 5.4%.
Conclusion: Prevalence of multidrug resistance in gram negative bacteria was high. Meropenem (91.8%) was the most active antibiotic against extended spectrum beta-lactamase producers while gentamicin (55.6%) for carbapenemase producers.
Description
This is to certify that the thesis prepared by Yasin Desalegn, entitled: āMultidrug resistance among fermentative and non-fermentative gram-negative bacilli isolated from clinical specimens at Arsho Advanced Medical Laboratory, Addis Ababa, Ethiopiaā and submitted in partial fulfillment of the requirements for Master of Science degree in Clinical Laboratory Sciences (Diagnostic and Public Health Microbiology) complies with the regulations of the University and meets the accepted standards with respect to originality and quality.
Keywords
Gram negative bacteria, Multidrug resistance, ESBLs, Carbapenemase.