High prevalence of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae fecal carriage among children under five years in Addis Ababa, Ethiopia.

<h4>Background</h4>Extended-spectrum beta-lactamase (ESBL) producing bacteria present an ever-growing burden in the hospital and community settings. Data on the prevalence of ESBL fecal carriage remain scarce in Ethiopia. Therefore, this study aimed to determine the prevalence of ESBL pr...

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Autores principales: Mekdes Alemu Tola, Negga Asamene Abera, Yonas Mekonnen Gebeyehu, Surafel Fentaw Dinku, Kassu Desta Tullu
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spelling oai:doaj.org-article:4587066200e740fd92bb5933ef00a8782021-12-02T20:17:25ZHigh prevalence of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae fecal carriage among children under five years in Addis Ababa, Ethiopia.1932-620310.1371/journal.pone.0258117https://doaj.org/article/4587066200e740fd92bb5933ef00a8782021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258117https://doaj.org/toc/1932-6203<h4>Background</h4>Extended-spectrum beta-lactamase (ESBL) producing bacteria present an ever-growing burden in the hospital and community settings. Data on the prevalence of ESBL fecal carriage remain scarce in Ethiopia. Therefore, this study aimed to determine the prevalence of ESBL producing Escherichia coli and Klebsiella pneumoniae fecal carriage among children under five years in Addis Ababa, Ethiopia.<h4>Methods</h4>A facility-based cross-sectional study was conducted from April to May 2017. A total of 269 fecal/rectal swab samples were cultured on MacConkey agar. All positive cultures were characterized by colony morphology, Gram stain, and standard biochemical tests. Further, bacteria identification, antimicrobial susceptibility testing, and phenotypic detection of ESBL production were performed using VITEK 2 Compact as per the instruction of the manufacturer. Socio-demographic and risk factors data were collected using questionnaires. Data were entered by EPI INFO version 7.2.1.0 and analyzed by SPSS version 20.<h4>Results</h4>The overall prevalence of ESBL-producing E. coli and K. pneumoniae was 17.1% (46/269; 95% CI: 12.9%-22.7%). A total of 47 isolates were ESBL-positive, of which, 83.0% were E. coli and 17.0% were K. pneumoniae. ESBL producing E. coli and K. pneumoniae isolates were also showed high levels of MDR (93.6%) and high rates of co-resistance to aminoglycosides, fluoroquinolones, and trimethoprim-sulfamethoxazole. However, all isolates were carbapenem susceptible. In the risk factors analysis, Children's mothers who had lower educational level (primary school) (OR: 2.472, 95% CI: 1.323-4.618, P = 0.0062) and children who used tap water for drinking (OR: 1.714, 95% CI: 1.001-3.659, P = 0.048) were found to be significantly associated with higher ESBL fecal carriage.<h4>Conclusions</h4>In this study, the high prevalence rate of ESBL producing E. coli and K. pneumoniae fecal carriage and high level of multidrug resistance among ESBL producing E. coli and K. pneumoniae were demonstrated. This suggested that the necessity of routine screening of ESBL is crucial for the early detection and appropriate antibiotics selection for infection caused by ESBL producing pathogens.Mekdes Alemu TolaNegga Asamene AberaYonas Mekonnen GebeyehuSurafel Fentaw DinkuKassu Desta TulluPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258117 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Mekdes Alemu Tola
Negga Asamene Abera
Yonas Mekonnen Gebeyehu
Surafel Fentaw Dinku
Kassu Desta Tullu
High prevalence of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae fecal carriage among children under five years in Addis Ababa, Ethiopia.
description <h4>Background</h4>Extended-spectrum beta-lactamase (ESBL) producing bacteria present an ever-growing burden in the hospital and community settings. Data on the prevalence of ESBL fecal carriage remain scarce in Ethiopia. Therefore, this study aimed to determine the prevalence of ESBL producing Escherichia coli and Klebsiella pneumoniae fecal carriage among children under five years in Addis Ababa, Ethiopia.<h4>Methods</h4>A facility-based cross-sectional study was conducted from April to May 2017. A total of 269 fecal/rectal swab samples were cultured on MacConkey agar. All positive cultures were characterized by colony morphology, Gram stain, and standard biochemical tests. Further, bacteria identification, antimicrobial susceptibility testing, and phenotypic detection of ESBL production were performed using VITEK 2 Compact as per the instruction of the manufacturer. Socio-demographic and risk factors data were collected using questionnaires. Data were entered by EPI INFO version 7.2.1.0 and analyzed by SPSS version 20.<h4>Results</h4>The overall prevalence of ESBL-producing E. coli and K. pneumoniae was 17.1% (46/269; 95% CI: 12.9%-22.7%). A total of 47 isolates were ESBL-positive, of which, 83.0% were E. coli and 17.0% were K. pneumoniae. ESBL producing E. coli and K. pneumoniae isolates were also showed high levels of MDR (93.6%) and high rates of co-resistance to aminoglycosides, fluoroquinolones, and trimethoprim-sulfamethoxazole. However, all isolates were carbapenem susceptible. In the risk factors analysis, Children's mothers who had lower educational level (primary school) (OR: 2.472, 95% CI: 1.323-4.618, P = 0.0062) and children who used tap water for drinking (OR: 1.714, 95% CI: 1.001-3.659, P = 0.048) were found to be significantly associated with higher ESBL fecal carriage.<h4>Conclusions</h4>In this study, the high prevalence rate of ESBL producing E. coli and K. pneumoniae fecal carriage and high level of multidrug resistance among ESBL producing E. coli and K. pneumoniae were demonstrated. This suggested that the necessity of routine screening of ESBL is crucial for the early detection and appropriate antibiotics selection for infection caused by ESBL producing pathogens.
format article
author Mekdes Alemu Tola
Negga Asamene Abera
Yonas Mekonnen Gebeyehu
Surafel Fentaw Dinku
Kassu Desta Tullu
author_facet Mekdes Alemu Tola
Negga Asamene Abera
Yonas Mekonnen Gebeyehu
Surafel Fentaw Dinku
Kassu Desta Tullu
author_sort Mekdes Alemu Tola
title High prevalence of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae fecal carriage among children under five years in Addis Ababa, Ethiopia.
title_short High prevalence of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae fecal carriage among children under five years in Addis Ababa, Ethiopia.
title_full High prevalence of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae fecal carriage among children under five years in Addis Ababa, Ethiopia.
title_fullStr High prevalence of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae fecal carriage among children under five years in Addis Ababa, Ethiopia.
title_full_unstemmed High prevalence of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae fecal carriage among children under five years in Addis Ababa, Ethiopia.
title_sort high prevalence of extended-spectrum beta-lactamase-producing escherichia coli and klebsiella pneumoniae fecal carriage among children under five years in addis ababa, ethiopia.
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/4587066200e740fd92bb5933ef00a878
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