Emergence of High Prevalence of Extended-Spectrum Beta-Lactamase and Carbapenemase Producing Acinetobacter Species and Pseudomonas aeruginosa Among Hospitalized Patients at Dessie Comprehensive Specialized Hospital, North-East Ethiopia

Abstract

Background

The emergence of extended spectrum beta lactamase and carbapenemase production of Acinetobacter and Pseudomonas aeruginosa is a great concern and major cause of nosocomial infections due to its ability to production of extended spectrum beta lactamase and carbapenemase enzymes.

Objective

To assess Emergence of high prevalence of extended-spectrum beta-lactamase and Carbapenemase producing Acinetobacter species and Pseudomonas aeruginosa among hospitalized patients at Dessie Comprehensive Specialized Hospital, North-East Ethiopia.

Materials and Methods

A hospital-based cross-sectional study was conducted from February–August 2021 at Dessie Referral Hospital in the North eastern Ethiopia. A total of 423 clinical samples taken from admitted patients. Clinical specimens were collected aseptically and inoculated on blood agar and MacConkey agar media. Antimicrobial susceptibility test, ESBL and carbapenemase production were performed as CLSI guideline. The data were entered into the Epi-data and imported to Statistical Package for Social Science version 25. P value of <0.05 with odds ratio and 95% confidence interval was considered as statistically significant.

Results

Out of 423 clinical specimens 17.7% (75/423) were culture positive nosocomial infection. The proportions of nosocomial infection were higher in blood stream followed by wound infection which accounted 24.6%, 20.8%, respectively. Overall, 32/75 (42.7%) and 19/75 (25.3%) patients had infection with ESBL and CP producing bacterial infection. P. aeruginosa was the most predominant isolated bacteria 46/75 (52.9%). The overall multidrug resistance rate of the isolated bacteria was 88% (66/75). The majority of highest resistance rate was Piperacillin tazobactam 50 (66.7%) and Aztreonam 26 (56.5%), respectively, while least resistance rate was Amikacin 27 (36%).

Conclusion

The incidence rates of ESBL, carbapenemase production and antimicrobial resistant Acinetobacter species and P. aeruginosa infections are high. Therefore, treatment should be based on culture and antimicrobial test result and minimize the use of antibiotics empirically.

Keywords:

• nosocomial infections
• extended-spectrum beta-lactamase
• carbapenemase
• Acinetobacter
• Pseudomonas aeruginosa
• drug resistance

Abbreviations

ATCC, American Type Culture Collection; AMR, Antimicrobial Resistance; BA, Blood Agar; BSI, Blood Stream Infection; CR, Carbapenem Resistance; CP, Carbapenemase Producing; CLSI, Clinical Laboratory and Standards Institute; DCSH, Dessie Comprehensive Specialized Hospital; ESBL, Extended Spectrum Beta-Lactamases; LRTI, Lower Respiratory Tract Infections; MAC, MacConkey Agar; MHA, Muller-Hilton Agar; NI, Nosocomial Infection; NICU, Neonatal Intensive care unit; SPSS, Statistical Package for Social Sciences; UTI, Urinary Tract Infection.

Data Sharing Statement

The findings of this study are based on the data that was collected and evaluated using the methods and materials that were specified. The manuscript contains all important information.

Acknowledgments

We would like to thank Dessie comprehensive specialty hospitals for allowing us to conduct our research in their facilities. We also appreciate the technical assistance provided by the Dessie comprehensive specialty hospitals’ staff. We also thank the Amhara Regional Health Bureau for allowing us to conduct the research in the Dessie comprehensive specialized hospitals. We also want to express our gratitude to all of the patients who took part in this research.

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agreed to be accountable for all aspects of the work.

Disclosure

The authors declared that no competing interest exists in this work.