Prevalence and Trends of Carbapenem-Resistant Pseudomonas aeruginosa and Acinetobacter Species Isolated from Clinical Specimens at the Ethiopian Public Health Institute, Addis Ababa, Ethiopia: A Retrospective Analysis

Figures & data

Figure 1 Data cleaning and analysis flowchart.

Abbreviation: N, Total number.

Figure 2 Carbapenem-resistant Acinetobacter species and P. aeruginosa distribution among different specimens.

Table 1 Distribution of Carbapenem-Resistant Isolates by Patient Demography, Health Facilities, and Wards

	Variables	Carbapenem Resistant Acinetobacter sp	Carbapenem Resistant P. aeruginosa	Total
Gender	Female	35	8	43
	Male	63	20	83
Age	<1 year	7	2	9
	1 to 10	6	2	8
	11 to 20	10	4	14
	21 to 30	29	6	35
	31 to 40	16	5	21
	41 to 50	10	3	13
	51 to 60	10	2	12
	Above 61	10	4	14
Health facility	AaBET Hospital	55	10	65
	Ras Desta hospital	7	2	9
	Saint Peter hospital	6	3	9
	Menelik II Hospital	4	1	5
	Federal Police hospital	3	2	5
	Saint Paul hospital	10	5	15
	Others	13	5	18
Wards	Pediatric	3	2	5
	Intensive care unit	30	8	38
	Emergency	28	6	34
	Medical	8	2	10
	Orthopdeic	3	1	4
	Surgical	5	2	7
	Outpatient	15	4	19
	Others	6	3	9

Table 2 Overall Antimicrobial Susceptibility Profile of Acinetobacter Species Isolates During 2017–2021

Organisms	Code	%R	%I	%S	%R 95%C.I.	Number
Acinetobacter sp.	TZP	85.5	5.3	9.2	75.2–92.2	76
	CAZ	94.6	0.0	5.4	86.0–98.3	74
	CRO	94.1	4.4	1.5	84.9–98.1	68
	FEP	90.0	2.9	7.1	79.9–95.5	70
	IPM	59.0	2.5	38.5	42.2–74.0	39
	MEM	61	2.5	36.5	50.4–66.0	161
	AMK	31.5	3.3	65.2	22.5–42.2	92
	GEN	64.3	2.7	33.0	54.6–73.0	112
	TOB	51.7	10.3	38	40.8–62.5	87
	CIP	79.9	0.6	19.5	72.5–85.7	154
	TCY	65.9	6.8	27.3	50.0–79.1	44

Abbreviations: TZP, piperacillin/tazobactam; CAZ, ceftazidime; CRO, ceftriaxone; FEP, cefepime; IPM, imipenem; MEM, meropenem; AMK, amikacin; GEN, gentamycin; TOB, tobramycin; CIP, ciprofloxacin; TCY, tetracycline; %R, percent resistant;%I, percent intermediate;%S, percent sensitive; C.I, confidence interval.

Table 3 Overall Antimicrobial Susceptibility Profile of P. aeruginosa Isolates During 2017–2021

Organisms	Code	%R	%I	%S	%R 95%C.I.	Number
P. aeruginosa	TZP	20.9	14.9	64.2	12.3–32.9	67
	CAZ	35.4	7.6	57.0	25.2–47.1	79
	FEP	42.1	10.5	47.4	29.4–55.9	57
	IPM	16.0	8.0	76.0	5.3–36.9	25
	MEM	22	0.8	77.2	14.0–28.7	128
	AMK	10.3	1.7	88	4.3–21.8	58
	GEN	12.9	1.2	85.9	6.9–22.4	85
	TOB	11.7	2.4	85.9	6.1–21.0	85
	CIP	24.8	15.4	59.8	17.5–33.8	117

Abbreviations: TZP, Piperacillin/tazobactam; CAZ, ceftazidime; FEP, cefepime; IPM, imipenem; MEM, meropenem; AMK, amikacin; GEN, gentamicin; TOB, tobramycin; CIP, ciprofloxacin;%R, percent resistant;%I, percent intermediate;%S, percent sensitive; C.I, confidence interval.

Table 4 Co-Resistance Profile of Carbapenem-Resistant Acinetobacter Species and P. aeruginosa to Other Antimicrobial Agents

Antimicrobia Agents	Acinetobacter sp.			P. aeruginosa
	%R	%I	%S	%R	%I	%S
Piperacillin	100	0	0	100	0	0
Piperacillin/Tazobactam	98	0	2	100	0	0
Ceftazidime	100	0	0	100	0	0
Ceftriaxone	100	0	0	IR	IR	IR
Cefepime	100	0	0	100	0	0
Amikacin	44	3	53	27	0	73
Gentamycin	76	4	20	55	0	45
Tobramycin	55	8	37	47	0	53
Ciprofloxacin	84	0	16	58	0	42
Trimethoprim/Sulfamethoxazole	94	1	5	IR	IR	IR
Tetracycline	67	6	27	IR	IR	IR

Abbreviations: %R, Percent resistant; %I, Percent intermediate; %S, Percent susceptibile; IR, intrinsically resistant.

Table 5 Carbapenem Resistance Trend of Acinetobacter Species and P. aeruginosa (2017–2021)

	2017		2018		2019		2020		2021		Total	(P value)
	N	nR (%R)	N	nR (%R)	N	nR (%R)	N	nR (%R)	N	nR (%R)	nR (%R)
Acinetobacter species	50	25 (50)	50	29 (58)	18	12 (66.7)	22	16 (73)	21	16 (76.2)	98 (61)	(0.013)↑
P. aeruginosa	33	10 (30.3)	34	3 (8.8)	33	8 (24.2)	6	2 (33.3)	22	5 (22.7)	28 (22)	(0.99)↑↓
Total	83	35 (42.1)	84	32 (38.1)	51	20 (39.2)	28	18 (64.3)	43	21 (47.7)	126 (48.8)	(0.13)

Notes: ↑, Statistically significant increasing resistance trends; ↑↓, Fluctuating trends.

Abbreviations: N, Total number; nR, Number resistant; %R, Percent resistant.