Emergence of Extended-Spectrum Beta-Lactamase and Carbapenemase Producing Gram Negative Non-Fermenters at Selected Hospitals of Northeast Ethiopia: A Prospective Cross-Sectional Study

Figures & data

Table 1 Prevalence of A. baumannii and P. aeruginosa and Demographic Characteristics of Patients at Selected Hospitals of North East Ethiopia

Variables	Number of Participants N (%)	A. baumannii N (%)	P. aeruginosa N (%)	Total N (%)	P-value
Age (years)
0.002 −5	57 (14.8)	8 (14)	0	8 (14)
6 −18	45 (11.7)	4 (8.9)	2 (4.4)	6 (13.3)
19–28	63 (16.4)	0	2 (3.2)	2 (3.2)
29–38	81 (21.1)	4 (4.9)	2 (2.5)	6 (7.4)	NA
39–48	55 (14.3)	2 (3.6)	4 (7.3)	6 (11)
49–58	45 (11.7)	0	0	0
> 58	38 (9.9)	2 (5.3)	0	2 (5.3)
Sex
Male	210 (54.7)	16 (7.6)	6 (2.8)	20 (10.6)	0.09
Female	174 (45.3)	4 (2.2)	4 (2.2)	8 (4.4)
Residence
Rural	225 (58.6)	4 (1.8)	8 (3.6)	12 (5.4)
Urban	159 (41.4)	16 (10)	2 (1.3)	18 (11.3)	0.08
Site of infections
Urinary tract	96 (25)	2 (2)	0	2 (2)	NA
Blood stream	96 (25)	10 (10.4)	0	10 (10.4)
Lower respiratory tract	96 (25)	4 (4.2)	2 (2)	6 (6.2)
Wound	96 (25)	4 (4.2)	8 (8.4)	12 (12.6)
Hospital patient setting
Outpatient	121 (31.5)	2 (1.6)	2 (1.6)	4 (3.2)
Inpatient	263 (68.5)	18 (6.8)	8 (3.0)	26 (9.9)	0.24
Total	384 (100)	20 (5.2)	10 (2.6)	20 (7.8)

Abbreviation: NA, not applicable.

Table 2 Distribution of ESBL and Carbapenemase Production and Carbapenem Resistance Among A. baumannii and P. aeruginosa Isolates from Patients at Selected Hospitals of North East Ethiopia

Type of Bacterial Isolates (n = 30)	ESBL Producer N (%)	Carbapenemase Producer N (%)	Carbapenem Resistance N (%)
A. baumannii (n = 20)	8 (40.0)	2 (10.0)	14 (70.0)
P. aeruginosa (n = 10)	8 (80.0)	2 (20.0)	6 (60.0)
Total	16 (53.3)	4 (13.3)	20 (66.7)

Table 3 Antibiotic Resistance Profiles of A. baumannii and P. aeruginosa Isolates from Participants Presumed to have Bacterial Infections at Selected Hospitals of North East Ethiopia

Antimicrobials	A. baumannii		P. aeruginosa		Total
	# T	R %	# T	R %	# T	R %
Amoxicillin- clavulanic acid	20	16 (80)	10	10 (100.)	20	26 (86.7)
Nitrofurantoin	20	12 (60)	10	10 (100)	20	22 (73.3)
Sulfamethoxazole-trimethoprim	20	20 (100)	10	6 (60)	20	26 (86.7)
Gentamicin	20	16 (80)	10	20 (100)	20	26 (86.7)
Chloramphenicol	20	20 (100)	10	10 (100.)	20	30 (100)
Ciprofloxacin	20	10 (50)	10	8 (80)	20	18 (60)
Cefotaxime	20	18 (90)	10	10 (100)	20	28 (93.3)
Ceftazidime	20	18 (90)	10	8 (80)	20	26 (86.7)
Cefoxitin	20	20 (100)	10	10 (100)	20	30 (100)
Meropenem	20	12 (60)	10	6 (60)	20	18 (60)
Ertapenem	20	10 (50)	10	6 (60)	20	16 (53.3)

Notes: # T: Number of isolates tested, R%: Percentage of resistant isolates.

Table 4 Antibiogram of A. baumannii and P. aeruginosa Isolates from Patients Clinically Presumed for Different Clinical Sites of Infections at Selected Hospitals of North East Ethiopia

Bacterial species	Level of Antibiotic Resistance
	R5	R6	R7	R8	R9	R10	Overall, MDR
A. baumannii (n = 20)	2 (1)	0	2 (1)	6 (30)	6 (30)	4 (20)	20 (100)
P. aeruginosa (n = 10)	0	0	0	0	10 (100)	0	10 (100)
Total (n = 30)	2 (6.7)	0	2 (6.7)	6 (20)	16 (53.3)	4 (13.3)	30 (100)

Notes: R5, 6, 7, 8, 9, 10 = Resistance to 5, 6, 7, 8, 9, 10 antibiotics in different classes; MDR = resistance to ≥ 3 antibiotics taken from different classes.

Table 5 Distribution of ESBL Producing and Carbapenem Resistant A. baumanii and P. aeruginosa Infection According to Different Variables of Study Participants at Selected Hospitals of North East Ethiopia (n = 384)

Variables	Number of participants N (%)	ESBL Positive N (%)	P-value	Carbapenem resistance N (%)	P-value
Sex				Positive
Female	174 (45.3)	6 (3.4)		4 (2.3)
Male	210 (54.7)	10 (4.8)	0.238	16 (7.6)	0.119
Residence
Rural	224 (58.4)	6 (2.7)		6 (2.7)
Urban	160 (41.6)	10 (6.3)	0.23	14 (8.8)	1.00
Hospital patient setting
Inpatient	263 (64.5)	12 (4.6)	0.35	18 (6.8)	0.18
Outpatient	121 (35.5)	4 (3.3)		2 (1.6)
Intravenous catheter in the last 12 months
Yes	92 (24)	8 (8.7)	0.015	8 (8.7)	0.225
No	292 (76)	8 (2.7)		12 (4.1)
Hospitalization in the last 12 months
Yes	97 (25.3)	10 (10.3)	0.007	12 (12.3)	0.04
No	287 (74.7)	6 (2.1)		8 (2.8)
Antibiotic use in the last 6 months
Yes	257 (66.9)	9 (3.5)		18 (7.0)	0.17
No	127 (33.1)	7 (5.5)	1.00	2 (1.6)
Surgery in the last 12 months
Yes	49 (12.8)	7 (14.3)	0.006	7 (14.3)	0.89
No	335 (87.2)	9 (2.7)		13 (3.9)
Chronic infection
Yes	64 (16.7)	4 (6.3)	0.69	3 (4.9)
No	320 (83.3)	12 (3.6)		17 (5.3)	0.32