Gastrointestinal Tract Colonization Rate of Extended-Spectrum Beta-Lactamase- and Carbapenemase-Producing Enterobacteriaceae and Associated Factors Among Hospitalized Patients in Arba Minch General Hospital, Arba Minch, Ethiopia

• Published in: Infection and drug resistance Vol. 13; pp. 1517 - 1526
• Main Authors: Aklilu, Addis, Manilal, Aseer, Ameya, Gemechu, Woldemariam, Melat, Siraj, Munira
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 2020; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Analysis; Antibiotics; Bacteria; Bacterial infections; Beta lactamases; Carbapenemase; Chronic diseases; Chronic illnesses; Colonization; Cotrimoxazole; Data collection; Drug resistance; Enterobacteriaceae; esbl; Escherichia coli; Gastrointestinal system; Gastrointestinal tract; Gynecology; Hospital patients; Hospitals; Infections; Klebsiella pneumoniae; Laboratories; Medical research; Microbial drug resistance; Mortality; Multidrug resistant organisms; Organisms; Original Research; Pediatrics; Pneumonia; Population; Public health; Risk factors; Statistical analysis; susceptibility; Tetracyclines; β Lactamase; Canada; Ethiopia; Addis Ababa Ethiopia; ESBL; enterobacteriaceae; gastrointestinal tract; susceptibility; colonization
• ISSN: 1178-6973; 1178-6973
• DOI: 10.2147/IDR.S239092

The incidence of hospital-acquired enterobacteria that produce extended-spectrum beta-lactamases (ESBLs) is on the rise worldwide. Colonization of gastrointestinal tract by extended-spectrum beta-lactamase Enterobacteriaceae, a prominent causative agent, results in life-threatening infections. To determine the rate of gastrointestinal colonization by extended-spectrum beta-lactamase- and carbapenemase-producing Enterobacteriaceae and also to elucidate the antibiotic susceptibility profile and associated risk factors among hospitalized patients in Arba Minch General Hospital, Ethiopia. A facility-based cross-sectional study was conducted in Arba Minch General Hospital from May 2018 to July 2019. Sociodemographic data and associated factors were collected using a pre-tested-structured questionnaire. Stool specimens were collected using sterile stool cups. Each sample was then inoculated onto MacConkey agar. Bacterial isolates were identified using various biochemical tests. Screening and confirmatory tests for extended-spectrum beta-lactamase- and carbapenemase-producing Enterobacteriaceae were performed using the modified Kirby-Bauer disc diffusion technique. Statistical package for Social Science was used to analyze the data. The P-value ≤0.05 was considered as statistically significant. A total of 421 hospitalized patients were enrolled in this study of which there were 240 (57%) females. The mean age of the study participants was 28.8 with SD of 15.7. Majority of participants were in the age range of 25-40 years 179 (42.5%). About 146 (34.7%) participants were found to be colonized by extended-spectrum beta-lactamase-producing Enterobacteriaceae. The predominant ESBL-producing isolates were 62 (42.46%) followed by 60 (41.09%). Six (1.43%) carbapenemase-producing were isolated. ESBL-producing Enterobacteriaceae showed higher resistance against tetracycline (91.1%) and cotrimoxazole (93.84%). Colonization of the gastrointestinal tract by ESBL showed statistically significant association with regard to chronic diseases (p<0.001) and the administration of oral antibiotics after admission (p=0.020). The overall colonization rate of the gastrointestinal tract by extended-spectrum beta-lactamase-producing Enterobacteriaceae was prominent. The extended-spectrum beta-lactamase-producing isolates exhibited a higher level of resistance against the commonly used antibiotics which further needs greater attention.