Journal article
Prevalence of rectal carbapenem resistant Enterobacterales carriage among patients attending healthcare facilities in Ibadan, Nigeria: a descriptive study
BMC infectious diseases, Vol.24(1), pp.726-9
07/24/2024
DOI: 10.1186/s12879-024-09627-z
PMCID: PMC11267743
PMID: 39048999
Abstract
Carbapenem Resistant Enterobacterales (CRE) infections are increasingly associated with or directly responsible for morbidity and mortality from bacterial infections in sub-Saharan Africa where there are limited antibiotic options. CRE rectal colonization of patients in healthcare facilities provides a reservoir of these organisms and could potentially cause invasive infections in these settings. The prevalence of rectal carriage among patients attending healthcare facilities in Nigeria has not been previously described. We set out to assess the prevalence of rectal CRE carriage and their antibiotic susceptibility patterns among patients attending healthcare facilities in Nigeria.
A descriptive cross-sectional study was carried out from December 2021 to September 2022 in Ibadan, in which patients attending primary, secondary and tertiary healthcare facilities were screened for rectal carriage of CRE by microscopy, culture and sensitivity of rectal swab specimens.
A total of 291 patients were screened; 45 (15.5%), 66 (22.7%) and 180 (61.8%) at primary, secondary and tertiary healthcare facilities, respectively. All but one of them had received a third-generation cephalosporin or carbapenem in the preceding 30 days. The mean age was 28.8 years and 55.7% were male. Overall, 51 (17.5%) participants had CRE colonization, with 5(11.1%), 9(13.6%) and 37(20.6%) at primary, secondary and tertiary healthcare facilities, respectively (p = 0.243). Regarding antimicrobial susceptibility, 43(84.3%) CRE isolates were resistant to at least 3 different classes of antibiotics while two Escherichia coli isolates were resistant to all 5 classes of antibiotics tested. The lowest rates of CRE resistance were to tigecycline (6, 11.5%) and colistin (8, 15.7%).
In this first study on CRE colonization in Nigeria, we found that a substantial proportion of patients in three levels of healthcare facilities had rectal carriage of CRE, including pan-resistant isolates. Active surveillance and appropriate infection prevention and control practices (IPC) need to be urgently strengthened to mitigate the risk of active CRE infection.
Not applicable.
Details
- Title: Subtitle
- Prevalence of rectal carbapenem resistant Enterobacterales carriage among patients attending healthcare facilities in Ibadan, Nigeria: a descriptive study
- Creators
- Olukemi Adekanmbi - University of IbadanOluwafemi Popoola - University of IbadanAdeola Fowotade - University of IbadanOlusola Idowu - University of IbadanBabatunde Ogunbosi - University of IbadanSulaiman Lakoh - University of Sierra LeoneIni Adebiyi - University College Hospital, IbadanOmobolaji Ayandipo - University College Hospital, IbadanAyodele Olukayode Iyun - University College Hospital, Ibadan
- Resource Type
- Journal article
- Publication Details
- BMC infectious diseases, Vol.24(1), pp.726-9
- DOI
- 10.1186/s12879-024-09627-z
- PMID
- 39048999
- PMCID
- PMC11267743
- NLM abbreviation
- BMC Infect Dis
- ISSN
- 1471-2334
- eISSN
- 1471-2334
- Grant note
- 54775481 / Pfizer
- Language
- English
- Date published
- 07/24/2024
- Academic Unit
- Anesthesia
- Record Identifier
- 9984787459402771
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