Prevalence of Extended-spectrum B-Lactemase and Carbapenemase Producing Enterobacteriaceae among Adult Patients Complaining UTI at South West Shoa, Lemman Hospital and Kersa Malimma Woreda Health Facility, Ethiopia
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Date
2021-02
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Addis Abeba University
Abstract
Background: Infection caused by Extended-spectrum beta-lactamase- (ESBLs) and Carbapenemase
producing Enterobacteriaceae (CPE) are serious problems of the world. Enterobacteriaceae are the most
important producers of ESBLs and Carbapenemase enzymes.
Objective: To determine the magnitude of Extended -spectrum B-Lactemase and Carbapenemase
producing Enterobacteriaceae patients complaining Urinary tract infection(UTI) at South West shoa,
lemman Hospital and kersa malima woreda health facility, Ethiopia
Methods: Across-sectional study was conducted from a total of278 symptomatic UTI suspected adult
patients fromSeptember1/2020 to December 30/ 2021. A convenient sampling technique was used to
enrolled patients in this study .Socio demographic data and other information was collected using
requisition form. Midstream urine samples were collected from each patient and inoculated onto
Macconkey and Sheep blood agar media. Inoculated plates were incubated at 37
C for 18-24 hours
aerobically. The identification of Enterobacteriaceae and gram positive bacteria were carried on based on
number of colonies, type of colonies, morphological appearance, and Gram reaction after growth on
culture media. Carbapenemase and ESBLs producing Enterobacteriaceae were performed by using
combination disk. Finally, data were analyzed using analytical binary regration SPSS version 24.
Results. The overall prevalence of Enterobacteriaceae isolates from urine cultures was 16.9 %(
47/278).The highest isolated bacteria were Escherichia coli 78.7% (37/47) and Klebsiella pneumoniae
were 8.5% (4/47). Most of them 51.1% (24/47) developed multidrug resistance (MDR≥3 drugs) to most
commonly used antibiotics. Prevalence of ESBL producing and Carbapenems resistance
Enterobacteriaceae was 44.7% and 0% respectively. The overall prevalence of ESBLs was 44.7%
(95%CI; OR=2.68,P=O.582) among all isolates and 18/21 (85.7%) of ESBLs isolates were identified
from females and 42.9 % (9/21) isolates were also indicated from patients with age group from 25-34
years.
Conclusion. ESBL β-lactamases producing Enterobacteriaceae were highly susceptible to
Carbapenemase, piperacillin/tazobactam and more susceptible Nitrofurantoin. Consequently, the argent
of ESBLs producing Enterobacteriaceae requires continuous testing& reviewing of antimicrobial
strategy in hospitals and health facility in this area are increased. All carbapenems strains are sensitive
(susceptible) for all Enterobacteriaceae isolates.
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Keywords
Carbapenemase, ESBLs producing, Enterobacteriaceae and symptomatic urinary tract infection