Faecal carriage of extended spectrum β-lactamase producing Enterobacterales (ESBL-PE) in children under five years of age at a tertiary hospital in southwest Nigeria

Background: The main reservoir of Enterobacterales is the human gut, which has been reported as a source of hospital acquired  infection. Enterobacterales carrying the extended spectrum β-lactamase (ESBL) genes have emerged over the years as significant  multidrug resistant (MDR) pathogens, that hav...

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Veröffentlicht in:African journal of clinical and experimental microbiology 2024-01, Vol.25 (1)
Hauptverfasser: Abayomi, S.A., Oladibu, O.T., Lawani, O.A., Owolabi, K.I., Alabi, A.O., Onigbinde, M.O.
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Sprache:eng
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Zusammenfassung:Background: The main reservoir of Enterobacterales is the human gut, which has been reported as a source of hospital acquired  infection. Enterobacterales carrying the extended spectrum β-lactamase (ESBL) genes have emerged over the years as significant  multidrug resistant (MDR) pathogens, that have hindered effective therapy of infections caused by them, and limited treatment to a small  number of drugs such as carbapenems, leading to selection pressure and emergent resistance to carbapenems. The objective of  this study was to determine the faecal carriage of ESBL-producing Enterobacterales (ESPL-PE) among children under 5 years of age at the Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Nigeria. Methodology: A total of 144 children under 5 years of age were consecutively recruited over a period of 5 months from the paediatrics outpatient clinic, children emergency, paediatrics ward, and neonatal unit of the hospital. Rectal swabs were collected from selected  children and transported to the medical microbiology laboratory of the hospital for inoculation on MacConkey agar plates and aerobic  incubation at 37oC for 24 hours. All positive growth on the culture plates were identified by colony morphology, Gram stain reaction and conventional biochemical tests scheme. Antimicrobial susceptibility test was performed by the disc diffusion method against selected  antibiotics, and ESBL production was confirmed by the double disc synergy test (DDST). Association of risk factors with ESBL-PE faecal  carriage was determined using Chi‑square or Fisher Exact test, with statistical significance set at p< 0.05. Results: The prevalence of ESBL-PE faecal carriage was 37.5% (54/144), with 34.7% (50/144) for Escherichia coli and 2.1% (3/144) for Klebsiella pneumoniae. The overall resistance rate of both ESBL and non-ESBL producing isolates were to ampicillin (100.0%), amoxicillin- clavulanic acid (96.2%), ceftazidime (94.3%) and ciprofloxacin (90.6%), while resistance to carbapenems was low at 22.2%. Significant risk  factors associated with ESBL-PE faecal carriage were age group 24-59 months (p=0.0187), prior intake of antibiotics (p=0.014), and intake  of antibiotics without prescription (p=0.0159), while gender (p=0.8877), mother’s education level (p=0.3831) and previous hospital visit  (p=0.8669) were not significantly associated with faecal ESBL carriage. Conclusion: The relatively high faecal carriage rate of ESBL-PE in  children
ISSN:1595-689X
1595-689X
DOI:10.4314/ajcem.v25i1.7