Magnitude and Drug Resistance Profile of Extended Spectrum β-Lactamase (ESBL) Producing Gram Negative Bacteria from Nasal Swabs Taken from Health Care workers and Inanimate Objects at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
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Date
2019-06
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Addis Abeba University
Abstract
Background:Hospital environment, inanimate objects and healthcare workers are likely to get colonized with diverse group of microbial agents. Infections caused by gram negative bacteria(GNB) are causing morbidity and mortality worldwide, gram negative bacteria which produce β-lactamase can result in multidrug resistance. The production of extended-spectrum β-lactamases(ESBLs) is an important mechanism which is responsible for the resistance to the third generation cephalosporin.
Objective: The objective of this study was to determine the magnitude and drug resistance profile of ESBL producing gram negative bacteria isolated from nasal swabs taken from healthcare workers (HCWs) and inanimate objects at Tikur Anbessa Specialized Hospital.
Methods: Both prospective and retrospective cross sectional study were conducted fromDecember 2018 to February 2019.Isolates from samples collected from an on-going PhD projectwere used for the purpose of the current study. The samples were taken from nasal swabs ofhealth care workers and inanimate objects. About 105and 216 isolates were randomly selectedfrom health care workers and inanimate objects respectively for further analysis. Biochemicaltests for identification and antimicrobial susceptibility test was done by disc diffusion method.Screening of ESBLs was done using Cefotaxime (30ug, BD), Ceftazidime (30ug, NJ54, QB14),ceftriaxone (30ug BD) discs. A combined disk diffusion test was used as confirmatory test. Thedata were analyzed using SPSS software (version 20) and descriptive statistical tests wereperformed
Results: Out of 105 isolates, 5 (4.8%) isolates were identified as Extended Spectrumβlactamases(ESBLs) producers, out of theses80% were Klebsiella spp (75% Klebsiellarhinoscleromatis, 25% Klebsiella pneumoniae) and 20% were Entrobacter cloacae. Three (60%)ESBL producing bacterial isolates were identified from Laboratory personnel and 2 (40%) werefrom Medical doctors. From environmental samples, 33/216 (15.3%) isolates were found to beESBL producers based on the confirmatory test (combined disk method). Different ESBLproducing gram negative bacteria, were isolated from the various inanimate objects of TASHincluding, Klebsiella ozaenae, Klebsiella oxytoca, Klebsiella pneumoniae, Klebsiellarhinoscleromatis,Citrobacter_spp, Escherichia coli, Serriatia_spp and Acinetobacter_spp. ESBL producing gram negative bacteria were found to be 100% resistant to ceftazidime andceftriaxone.
Conclusion: It is worrisome to detect ESBL producing gram negative bacteria from theinanimate objects of TASH and the nasal cavity of some HCWs, calling for systematic screening of inanimate objects for ESBL and other multidrug resistant bacteria in the hospital.Furthermore, strengthening the infection prevention practice is vital to halt transmission of thesenoxious bugs.
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ESBL, Inanimate objects, HCWS