Magnitude and Molecular Characterization of Extended-Spectrum β-Lactamase Genes among Klebsiella pneumoniae Isolates in a Large Tertiary Hospital in Ethiopia

Tewachew Awoke; Brhanu Teka; Abraham Aseffa; Aminu Seman; Shemse Sebre; Berhanu Yitayew; Biruk Yeshitela; Tamrat Abebe; Adane Mihret

doi:10.1007/5584_2022_739

Magnitude and Molecular Characterization of Extended-Spectrum β-Lactamase Genes among Klebsiella pneumoniae Isolates in a Large Tertiary Hospital in Ethiopia

Adv Exp Med Biol. 2023:1370:91-102. doi: 10.1007/5584_2022_739.

Authors

Tewachew Awoke¹, Brhanu Teka², Abraham Aseffa³, Aminu Seman², Shemse Sebre², Berhanu Yitayew⁴, Biruk Yeshitela³, Tamrat Abebe², Adane Mihret^{2

3}

Affiliations

¹ Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia. tewaslike@gmail.com.
² Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
³ Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
⁴ College of Medicine, Institute of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia.

PMID: 36318402
DOI: 10.1007/5584_2022_739

Abstract

Background Extended-spectrum β-lactamases (ESBLs)-producing Klebsiella pneumoniae is reported worldwide increasingly. However, studies on ESBLs are still scarce in Ethiopia. Therefore, the current study aimed to determine the magnitude and resistance patterns of ESBL-producing K. pneumoniae as well as the frequency of ESBL-encoding genes.Methods A cross-sectional study was conducted from September 2018 to February 2019 at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia among a total of 132 non-duplicate K. pneumoniae isolates. Phenotypic detection of ESBL production was done using Combined Disc Test. ESBL-encoding genes of bla_CTX-M, bla_TEM, and bla_SHV were detected through multiplex PCR.Results The magnitude of ESBL production was 102/132 (77.3%). ESBL positive isolates were 100% resistant to ceftriaxone, cefotaxime, and cefuroxime. Co-resistance of ESBL-positive isolates to other non β-lactam antimicrobials was high to trimethoprim-sulfamethoxazole (96.1%) followed by tetracycline (75.5%) and gentamicin (73.5%). However, these isolates showed high susceptibility to amikacin (96.1%) and meropenem (89.2%). From the total ESBL-positive isolates, 82.6%, 73.5%, and 75% carried bla_CTX-M, bla_TEM, and bla_SHV genes, respectively. The majority 78/102 (76.5%) of ESBL-positive isolates harbored all three types of ESBL genes simultaneously.Conclusions The magnitude of ESBL-producing K. pneumoniae isolates was very alarming in the study area. The co-occurrence of bla_CTX-M, bla_TEM, and bla_SHV genes is high, demanding large-scale studies to evaluate the presence of antimicrobial resistance super-clones. ESBL-producing isolates showed high resistance to most of the antimicrobials, needing phenotypic detection of ESBL regularly for better management of patients.

Keywords: Antimicrobial susceptibility; ESBL genes; Ethiopia; Extended-spectrum-beta-lactamase; Klebsiella pneumoniae.

MeSH terms

Anti-Bacterial Agents / pharmacology
Anti-Bacterial Agents / therapeutic use
Cross-Sectional Studies
Ethiopia / epidemiology
Humans
Klebsiella Infections* / drug therapy
Klebsiella Infections* / epidemiology
Klebsiella Infections* / genetics
Klebsiella pneumoniae* / genetics
Microbial Sensitivity Tests
Tertiary Care Centers
beta-Lactamases / genetics

Substances

beta-Lactamases
Anti-Bacterial Agents