Prevalence and patient related factors associated with Extended-Spectrum Beta-Lactamase producing Escherichia coli and Klebsiella pneumoniae carriage and infection among pediatric patients in Tanzania

Abstract Extended-Spectrum Beta-Lactamase (ESBL) producing Enterobacteriaceae (EPE) is increasing worldwide, though less documented in low-income settings. Here we determined the prevalence of EPE infection and carriage, and patient factors associated with EPE-carriage among pediatric patients in th...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Nuru Letara, James Samwel Ngocho, Nahid Karami, Sia E. Msuya, Balthazar Nyombi, Nancy A. Kassam, Susann Skovbjerg, Christina Åhren, Rune Philemon, Blandina T. Mmbaga
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/fe2c6a89015a4f6083d5e385ae37fa3d
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:fe2c6a89015a4f6083d5e385ae37fa3d
record_format	dspace
spelling	oai:doaj.org-article:fe2c6a89015a4f6083d5e385ae37fa3d2021-11-28T12:19:36ZPrevalence and patient related factors associated with Extended-Spectrum Beta-Lactamase producing Escherichia coli and Klebsiella pneumoniae carriage and infection among pediatric patients in Tanzania10.1038/s41598-021-02186-22045-2322https://doaj.org/article/fe2c6a89015a4f6083d5e385ae37fa3d2021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-02186-2https://doaj.org/toc/2045-2322Abstract Extended-Spectrum Beta-Lactamase (ESBL) producing Enterobacteriaceae (EPE) is increasing worldwide, though less documented in low-income settings. Here we determined the prevalence of EPE infection and carriage, and patient factors associated with EPE-carriage among pediatric patients in three health care levels in Tanzania. Between January and April 2016, 350 febrile children (median age 21 months) seeking care at a university or a regional referral hospital, or a health centre in Moshi municipality, Tanzania, were included. Socio-demographic characteristics were collected using a questionnaire. Rectal swabs and blood cultures were collected from all children (n = 350) and urinary samples from 259 children at admission. ESBL-phenotype and antimicrobial susceptibility were determined for Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. coli) isolates. Only one EPE case (E. coli) in blood and four in urine (one E. coli and three K. pneumoniae) were found, whereas (n = 90, 26%) of the children were colonized in feces (ESBL-E. coli; n = 76, ESBL-K. pneumoniae, n = 14). High resistance rates were seen in fecal ESBL-E. coli (n = 76) against trimethoprim-sulfamethoxazole (n = 69, 91%), gentamicin (n = 51, 67%), ciprofloxacin (n = 39, 51%) and chloramphenicol (n = 27, 35%) whereas most isolates were sensitive to amikacin (n = 71, 93%). Similar rates were seen for fecal ESBL-K. pneumoniae. Resistance to first line antibiotics were also very high in fecal E. coli not producing ESBL. No sociodemographic factor was associated with EPE-carriage. Children colonized with EPE were younger than 12 months (n = 43, 48%) and often treated with antibiotics (n = 40, 44%) in the previous two months. After adjustment for age children admitted to the intensive care unit had higher odds of EPE fecal carriage compared with those in the general wards (OR = 3.9, 95%CI = 1.4–10.4). Despite comparatively high rates of fecal EPE-carriage and previous antibiotic treatment, clinical EPE cases were rare in the febrile children. The very high resistant rates for the EPE and the non-ESBL producing E. coli to commonly used antibiotics are worrying and demand implementation of antibiotic stewardship programs in all levels of health care in Tanzania.Nuru LetaraJames Samwel NgochoNahid KaramiSia E. MsuyaBalthazar NyombiNancy A. KassamSusann SkovbjergChristina ÅhrenRune PhilemonBlandina T. MmbagaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Nuru Letara James Samwel Ngocho Nahid Karami Sia E. Msuya Balthazar Nyombi Nancy A. Kassam Susann Skovbjerg Christina Åhren Rune Philemon Blandina T. Mmbaga Prevalence and patient related factors associated with Extended-Spectrum Beta-Lactamase producing Escherichia coli and Klebsiella pneumoniae carriage and infection among pediatric patients in Tanzania
description	Abstract Extended-Spectrum Beta-Lactamase (ESBL) producing Enterobacteriaceae (EPE) is increasing worldwide, though less documented in low-income settings. Here we determined the prevalence of EPE infection and carriage, and patient factors associated with EPE-carriage among pediatric patients in three health care levels in Tanzania. Between January and April 2016, 350 febrile children (median age 21 months) seeking care at a university or a regional referral hospital, or a health centre in Moshi municipality, Tanzania, were included. Socio-demographic characteristics were collected using a questionnaire. Rectal swabs and blood cultures were collected from all children (n = 350) and urinary samples from 259 children at admission. ESBL-phenotype and antimicrobial susceptibility were determined for Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. coli) isolates. Only one EPE case (E. coli) in blood and four in urine (one E. coli and three K. pneumoniae) were found, whereas (n = 90, 26%) of the children were colonized in feces (ESBL-E. coli; n = 76, ESBL-K. pneumoniae, n = 14). High resistance rates were seen in fecal ESBL-E. coli (n = 76) against trimethoprim-sulfamethoxazole (n = 69, 91%), gentamicin (n = 51, 67%), ciprofloxacin (n = 39, 51%) and chloramphenicol (n = 27, 35%) whereas most isolates were sensitive to amikacin (n = 71, 93%). Similar rates were seen for fecal ESBL-K. pneumoniae. Resistance to first line antibiotics were also very high in fecal E. coli not producing ESBL. No sociodemographic factor was associated with EPE-carriage. Children colonized with EPE were younger than 12 months (n = 43, 48%) and often treated with antibiotics (n = 40, 44%) in the previous two months. After adjustment for age children admitted to the intensive care unit had higher odds of EPE fecal carriage compared with those in the general wards (OR = 3.9, 95%CI = 1.4–10.4). Despite comparatively high rates of fecal EPE-carriage and previous antibiotic treatment, clinical EPE cases were rare in the febrile children. The very high resistant rates for the EPE and the non-ESBL producing E. coli to commonly used antibiotics are worrying and demand implementation of antibiotic stewardship programs in all levels of health care in Tanzania.
format	article
author	Nuru Letara James Samwel Ngocho Nahid Karami Sia E. Msuya Balthazar Nyombi Nancy A. Kassam Susann Skovbjerg Christina Åhren Rune Philemon Blandina T. Mmbaga
author_facet	Nuru Letara James Samwel Ngocho Nahid Karami Sia E. Msuya Balthazar Nyombi Nancy A. Kassam Susann Skovbjerg Christina Åhren Rune Philemon Blandina T. Mmbaga
author_sort	Nuru Letara
title	Prevalence and patient related factors associated with Extended-Spectrum Beta-Lactamase producing Escherichia coli and Klebsiella pneumoniae carriage and infection among pediatric patients in Tanzania
title_short	Prevalence and patient related factors associated with Extended-Spectrum Beta-Lactamase producing Escherichia coli and Klebsiella pneumoniae carriage and infection among pediatric patients in Tanzania
title_full	Prevalence and patient related factors associated with Extended-Spectrum Beta-Lactamase producing Escherichia coli and Klebsiella pneumoniae carriage and infection among pediatric patients in Tanzania
title_fullStr	Prevalence and patient related factors associated with Extended-Spectrum Beta-Lactamase producing Escherichia coli and Klebsiella pneumoniae carriage and infection among pediatric patients in Tanzania
title_full_unstemmed	Prevalence and patient related factors associated with Extended-Spectrum Beta-Lactamase producing Escherichia coli and Klebsiella pneumoniae carriage and infection among pediatric patients in Tanzania
title_sort	prevalence and patient related factors associated with extended-spectrum beta-lactamase producing escherichia coli and klebsiella pneumoniae carriage and infection among pediatric patients in tanzania
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/fe2c6a89015a4f6083d5e385ae37fa3d
work_keys_str_mv	AT nuruletara prevalenceandpatientrelatedfactorsassociatedwithextendedspectrumbetalactamaseproducingescherichiacoliandklebsiellapneumoniaecarriageandinfectionamongpediatricpatientsintanzania AT jamessamwelngocho prevalenceandpatientrelatedfactorsassociatedwithextendedspectrumbetalactamaseproducingescherichiacoliandklebsiellapneumoniaecarriageandinfectionamongpediatricpatientsintanzania AT nahidkarami prevalenceandpatientrelatedfactorsassociatedwithextendedspectrumbetalactamaseproducingescherichiacoliandklebsiellapneumoniaecarriageandinfectionamongpediatricpatientsintanzania AT siaemsuya prevalenceandpatientrelatedfactorsassociatedwithextendedspectrumbetalactamaseproducingescherichiacoliandklebsiellapneumoniaecarriageandinfectionamongpediatricpatientsintanzania AT balthazarnyombi prevalenceandpatientrelatedfactorsassociatedwithextendedspectrumbetalactamaseproducingescherichiacoliandklebsiellapneumoniaecarriageandinfectionamongpediatricpatientsintanzania AT nancyakassam prevalenceandpatientrelatedfactorsassociatedwithextendedspectrumbetalactamaseproducingescherichiacoliandklebsiellapneumoniaecarriageandinfectionamongpediatricpatientsintanzania AT susannskovbjerg prevalenceandpatientrelatedfactorsassociatedwithextendedspectrumbetalactamaseproducingescherichiacoliandklebsiellapneumoniaecarriageandinfectionamongpediatricpatientsintanzania AT christinaahren prevalenceandpatientrelatedfactorsassociatedwithextendedspectrumbetalactamaseproducingescherichiacoliandklebsiellapneumoniaecarriageandinfectionamongpediatricpatientsintanzania AT runephilemon prevalenceandpatientrelatedfactorsassociatedwithextendedspectrumbetalactamaseproducingescherichiacoliandklebsiellapneumoniaecarriageandinfectionamongpediatricpatientsintanzania AT blandinatmmbaga prevalenceandpatientrelatedfactorsassociatedwithextendedspectrumbetalactamaseproducingescherichiacoliandklebsiellapneumoniaecarriageandinfectionamongpediatricpatientsintanzania
_version_	1718408117229715456

Prevalence and patient related factors associated with Extended-Spectrum Beta-Lactamase producing Escherichia coli and Klebsiella pneumoniae carriage and infection among pediatric patients in Tanzania

Ejemplares similares