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) andCarbapenemaseproducing 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 Carbapenemaseproducing 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 adultpatients fromSeptember1/2020 to December 30/ 2021. A convenient sampling technique was used toenrolled patients in this study .Socio demographic data and other information was collected usingrequisition form. Midstream urine samples were collected from each patient and inoculated ontoMacconkey and Sheep blood agar media. Inoculated plates were incubated at 37C for 18-24 hoursaerobically. The identification of Enterobacteriaceae and gram positive bacteria were carried on based onnumber of colonies, type of colonies, morphological appearance, and Gram reaction after growth onculture media. Carbapenemase and ESBLs producing Enterobacteriaceae were performed by usingcombination 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 pneumoniaewere 8.5% (4/47). Most of them 51.1% (24/47) developed multidrug resistance (MDR≥3 drugs) to mostcommonly used antibiotics. Prevalence of ESBL producing and Carbapenems resistanceEnterobacteriaceae 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 identifiedfrom females and 42.9 % (9/21) isolates were also indicated from patients with age group from 25-34years.
Conclusion. ESBL β-lactamases producing Enterobacteriaceae were highly susceptible toCarbapenemase, piperacillin/tazobactam and more susceptible Nitrofurantoin. Consequently, the argentof ESBLs producing Enterobacteriaceae requires continuous testing& reviewing of antimicrobialstrategy 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