Very high prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae in bacteriemic patients hospitalized in teaching hospitals in Bamako, Mali
The worldwide dissemination of extended-spectrum beta-lactamase producing Enterobacteriaceae, (ESBL-E) and their subset producing carbapenemases (CPE), is alarming. Limited data on the prevalence of such strains in infections from patients from Sub-Saharan Africa are currently available. We determin...
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| Veröffentlicht in: | PloS one 2017-02, Vol.12 (2), p.e0172652-e0172652 |
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| creator | Sangare, Samba Adama Rondinaud, Emilie Maataoui, Naouale Maiga, Almoustapha Issiaka Guindo, Ibrehima Maiga, Aminata Camara, Namory Dicko, Oumar Agaly Dao, Sounkalo Diallo, Souleymane Bougoudogo, Flabou Andremont, Antoine Maiga, Ibrahim Izetiegouma Armand-Lefevre, Laurence |
| description | The worldwide dissemination of extended-spectrum beta-lactamase producing Enterobacteriaceae, (ESBL-E) and their subset producing carbapenemases (CPE), is alarming. Limited data on the prevalence of such strains in infections from patients from Sub-Saharan Africa are currently available. We determined, here, the prevalence of ESBL-E/CPE in bacteriemic patients in two teaching hospitals from Bamako (Mali), which are at the top of the health care pyramid in the country. During one year, all Enterobacteriaceae isolated from bloodstream infections (E-BSI), were collected from patients hospitalized at the Point G University Teaching Hospital and the pediatric units of Gabriel Touré University Teaching Hospital. Antibiotic susceptibility testing, enzyme characterization and strain relatedness were determined. A total of 77 patients had an E-BSI and as many as 48 (62.3%) were infected with an ESBL-E. ESBL-E BSI were associated with a previous hospitalization (OR 3.97 95% IC [1.32; 13.21]) and were more frequent in hospital-acquired episodes (OR 3.66 95% IC [1.07; 13.38]). Among the 82 isolated Enterobacteriaceae, 58.5% were ESBL-E (20/31 Escherichia coli, 20/26 Klebsiella pneumoniae and 8/15 Enterobacter cloacae). The remaining (5 Salmonella Enteritidis, 3 Morganella morganii 1 Proteus mirabilis and 1 Leclercia adecarboxylata) were ESBL negative. CTX-M-1 group enzymes were highly prevalent (89.6%) among ESBLs; the remaining ones being SHV. One E. coli produced an OXA-181 carbapenemase, which is the first CPE described in Mali. The analysis of ESBL-E relatedness suggested a high rate of cross transmission between patients. In conclusion, even if CPE are still rare for the moment, the high rate of ESBL-BSI and frequent cross transmission probably impose a high medical and economic burden to Malian hospitals. |
| doi_str_mv | 10.1371/journal.pone.0172652 |
| format | Article |
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Limited data on the prevalence of such strains in infections from patients from Sub-Saharan Africa are currently available. We determined, here, the prevalence of ESBL-E/CPE in bacteriemic patients in two teaching hospitals from Bamako (Mali), which are at the top of the health care pyramid in the country. During one year, all Enterobacteriaceae isolated from bloodstream infections (E-BSI), were collected from patients hospitalized at the Point G University Teaching Hospital and the pediatric units of Gabriel Touré University Teaching Hospital. Antibiotic susceptibility testing, enzyme characterization and strain relatedness were determined. A total of 77 patients had an E-BSI and as many as 48 (62.3%) were infected with an ESBL-E. ESBL-E BSI were associated with a previous hospitalization (OR 3.97 95% IC [1.32; 13.21]) and were more frequent in hospital-acquired episodes (OR 3.66 95% IC [1.07; 13.38]). Among the 82 isolated Enterobacteriaceae, 58.5% were ESBL-E (20/31 Escherichia coli, 20/26 Klebsiella pneumoniae and 8/15 Enterobacter cloacae). The remaining (5 Salmonella Enteritidis, 3 Morganella morganii 1 Proteus mirabilis and 1 Leclercia adecarboxylata) were ESBL negative. CTX-M-1 group enzymes were highly prevalent (89.6%) among ESBLs; the remaining ones being SHV. One E. coli produced an OXA-181 carbapenemase, which is the first CPE described in Mali. The analysis of ESBL-E relatedness suggested a high rate of cross transmission between patients. In conclusion, even if CPE are still rare for the moment, the high rate of ESBL-BSI and frequent cross transmission probably impose a high medical and economic burden to Malian hospitals.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0172652</identifier><identifier>PMID: 28245252</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents - pharmacology ; Antibiotics ; Bacteremia - microbiology ; Bacterial infections ; Bacteriology ; Bernard, Claude (1813-1878) ; Beta lactamases ; beta-Lactamases - metabolism ; Biology and Life Sciences ; Carbapenemase ; Drug Resistance, Bacterial ; E coli ; Enterobacter cloacae ; Enterobacter cloacae - drug effects ; Enterobacter cloacae - physiology ; Enterobacteriaceae ; Enterobacteriaceae - drug effects ; Enterobacteriaceae - enzymology ; Enterobacteriaceae - isolation & purification ; Enterobacteriaceae - physiology ; Enzymes ; Escherichia coli ; Escherichia coli - drug effects ; Escherichia coli - physiology ; Female ; Genetic aspects ; Health aspects ; Health care ; Hospital patients ; Hospitalization ; Hospitals ; Hospitals, Teaching - statistics & numerical data ; Humans ; Infections ; Klebsiella ; Klebsiella pneumoniae ; Klebsiella pneumoniae - drug effects ; Klebsiella pneumoniae - physiology ; Laboratories ; Leclercia adecarboxylata ; Male ; Mali ; Medicine and Health Sciences ; Middle Aged ; Morganella morganii ; Morganella morganii - drug effects ; Morganella morganii - physiology ; Nosocomial infections ; Patients ; Pediatrics ; Prevalence ; Prospective Studies ; Proteus mirabilis ; Salmonella ; Salmonella enteritidis ; Teaching hospitals ; Young Adult ; β Lactamase</subject><ispartof>PloS one, 2017-02, Vol.12 (2), p.e0172652-e0172652</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Sangare et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Sangare et al 2017 Sangare et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c791t-b379bd00dd2dd2d27e381efc218407f8080e4cf51ff828902adbd437c632e67f3</citedby><cites>FETCH-LOGICAL-c791t-b379bd00dd2dd2d27e381efc218407f8080e4cf51ff828902adbd437c632e67f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5330466/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5330466/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,866,887,2104,2930,23873,27931,27932,53798,53800</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28245252$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Gonzalez-Bello, Concepción</contributor><creatorcontrib>Sangare, Samba Adama</creatorcontrib><creatorcontrib>Rondinaud, Emilie</creatorcontrib><creatorcontrib>Maataoui, Naouale</creatorcontrib><creatorcontrib>Maiga, Almoustapha Issiaka</creatorcontrib><creatorcontrib>Guindo, Ibrehima</creatorcontrib><creatorcontrib>Maiga, Aminata</creatorcontrib><creatorcontrib>Camara, Namory</creatorcontrib><creatorcontrib>Dicko, Oumar Agaly</creatorcontrib><creatorcontrib>Dao, Sounkalo</creatorcontrib><creatorcontrib>Diallo, Souleymane</creatorcontrib><creatorcontrib>Bougoudogo, Flabou</creatorcontrib><creatorcontrib>Andremont, Antoine</creatorcontrib><creatorcontrib>Maiga, Ibrahim Izetiegouma</creatorcontrib><creatorcontrib>Armand-Lefevre, Laurence</creatorcontrib><title>Very high prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae in bacteriemic patients hospitalized in teaching hospitals in Bamako, Mali</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The worldwide dissemination of extended-spectrum beta-lactamase producing Enterobacteriaceae, (ESBL-E) and their subset producing carbapenemases (CPE), is alarming. Limited data on the prevalence of such strains in infections from patients from Sub-Saharan Africa are currently available. We determined, here, the prevalence of ESBL-E/CPE in bacteriemic patients in two teaching hospitals from Bamako (Mali), which are at the top of the health care pyramid in the country. During one year, all Enterobacteriaceae isolated from bloodstream infections (E-BSI), were collected from patients hospitalized at the Point G University Teaching Hospital and the pediatric units of Gabriel Touré University Teaching Hospital. Antibiotic susceptibility testing, enzyme characterization and strain relatedness were determined. A total of 77 patients had an E-BSI and as many as 48 (62.3%) were infected with an ESBL-E. ESBL-E BSI were associated with a previous hospitalization (OR 3.97 95% IC [1.32; 13.21]) and were more frequent in hospital-acquired episodes (OR 3.66 95% IC [1.07; 13.38]). Among the 82 isolated Enterobacteriaceae, 58.5% were ESBL-E (20/31 Escherichia coli, 20/26 Klebsiella pneumoniae and 8/15 Enterobacter cloacae). The remaining (5 Salmonella Enteritidis, 3 Morganella morganii 1 Proteus mirabilis and 1 Leclercia adecarboxylata) were ESBL negative. CTX-M-1 group enzymes were highly prevalent (89.6%) among ESBLs; the remaining ones being SHV. One E. coli produced an OXA-181 carbapenemase, which is the first CPE described in Mali. The analysis of ESBL-E relatedness suggested a high rate of cross transmission between patients. In conclusion, even if CPE are still rare for the moment, the high rate of ESBL-BSI and frequent cross transmission probably impose a high medical and economic burden to Malian hospitals.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Antibiotics</subject><subject>Bacteremia - microbiology</subject><subject>Bacterial infections</subject><subject>Bacteriology</subject><subject>Bernard, Claude (1813-1878)</subject><subject>Beta lactamases</subject><subject>beta-Lactamases - metabolism</subject><subject>Biology and Life Sciences</subject><subject>Carbapenemase</subject><subject>Drug Resistance, Bacterial</subject><subject>E coli</subject><subject>Enterobacter cloacae</subject><subject>Enterobacter cloacae - drug effects</subject><subject>Enterobacter cloacae - physiology</subject><subject>Enterobacteriaceae</subject><subject>Enterobacteriaceae - drug effects</subject><subject>Enterobacteriaceae - 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drug effects</subject><subject>Morganella morganii - physiology</subject><subject>Nosocomial infections</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Proteus mirabilis</subject><subject>Salmonella</subject><subject>Salmonella enteritidis</subject><subject>Teaching hospitals</subject><subject>Young Adult</subject><subject>β Lactamase</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk21r1TAUx4sobk6_gWhhIAr2moe2ad8Ic0wdTAY-7G1Ik5PbXHubmqTD-Wn8qKa7vWNX9mI00Pac3_nn5OScJHmO0QJTht-t7Oh60S0G28MCYUbKgjxI9nFNSVYSRB_e-t5Lnni_QqigVVk-TvZIRfKCFGQ_-XsB7iptzbJNBweXooNeQmp1Cr8D9ApU5geQwY3rtIEgsk7IINbCQzY4q0Zp-mV60gdwtokecEZIEJCaPp3_YW1kOohgoA8-ba0fTBCd-QNqggII2U4aW4efrB_iDj_t2_RLBJ8mj3Q0w7P5fZD8-Hjy_fhzdnb-6fT46CyTrMYhayirG4WQUmRahAGtMGhJcJUjpitUIcilLrDWFalqRIRqVE6ZLCmBkml6kLzc6A6d9Xwurue4YoRVdV3UkTjdEMqKFR-cWQt3xa0w_Npg3ZILF4zsgGvKhKC6aDQROZRCyJhViRrV1ERjnUet9_NuY7MGJWNxnOh2RHc9vWn50l7yglKUl2UUeD0LOPtrBB_42ngJXSd6sON13qyiNcbsPijNES7q6YiH_6F3F2KmlrFduOm1jSnKSZQf5RXNGSryiVrcQcVHTS0Rm1abaN8JeLMTEJkQu3ApRu_56bev92fPL3bZV7fYFkQXWm-7MRjb-10w34DSWe8d6Jv7wIhPM7etBp9mjs8zF8Ne3L7Lm6DtkNF__owq8Q</recordid><startdate>20170228</startdate><enddate>20170228</enddate><creator>Sangare, Samba Adama</creator><creator>Rondinaud, Emilie</creator><creator>Maataoui, Naouale</creator><creator>Maiga, Almoustapha Issiaka</creator><creator>Guindo, Ibrehima</creator><creator>Maiga, Aminata</creator><creator>Camara, Namory</creator><creator>Dicko, Oumar Agaly</creator><creator>Dao, Sounkalo</creator><creator>Diallo, Souleymane</creator><creator>Bougoudogo, Flabou</creator><creator>Andremont, Antoine</creator><creator>Maiga, Ibrahim Izetiegouma</creator><creator>Armand-Lefevre, Laurence</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20170228</creationdate><title>Very high prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae in bacteriemic patients hospitalized in teaching hospitals in Bamako, Mali</title><author>Sangare, Samba Adama ; Rondinaud, Emilie ; Maataoui, Naouale ; Maiga, Almoustapha Issiaka ; Guindo, Ibrehima ; Maiga, Aminata ; Camara, Namory ; Dicko, Oumar Agaly ; Dao, Sounkalo ; Diallo, Souleymane ; Bougoudogo, Flabou ; Andremont, Antoine ; Maiga, Ibrahim Izetiegouma ; Armand-Lefevre, Laurence</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c791t-b379bd00dd2dd2d27e381efc218407f8080e4cf51ff828902adbd437c632e67f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Antibiotics</topic><topic>Bacteremia - microbiology</topic><topic>Bacterial infections</topic><topic>Bacteriology</topic><topic>Bernard, Claude (1813-1878)</topic><topic>Beta lactamases</topic><topic>beta-Lactamases - metabolism</topic><topic>Biology and Life Sciences</topic><topic>Carbapenemase</topic><topic>Drug Resistance, Bacterial</topic><topic>E coli</topic><topic>Enterobacter cloacae</topic><topic>Enterobacter cloacae - drug effects</topic><topic>Enterobacter cloacae - physiology</topic><topic>Enterobacteriaceae</topic><topic>Enterobacteriaceae - drug effects</topic><topic>Enterobacteriaceae - enzymology</topic><topic>Enterobacteriaceae - isolation & purification</topic><topic>Enterobacteriaceae - physiology</topic><topic>Enzymes</topic><topic>Escherichia coli</topic><topic>Escherichia coli - drug effects</topic><topic>Escherichia coli - physiology</topic><topic>Female</topic><topic>Genetic aspects</topic><topic>Health aspects</topic><topic>Health care</topic><topic>Hospital patients</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Hospitals, Teaching - statistics & numerical data</topic><topic>Humans</topic><topic>Infections</topic><topic>Klebsiella</topic><topic>Klebsiella pneumoniae</topic><topic>Klebsiella pneumoniae - drug effects</topic><topic>Klebsiella pneumoniae - physiology</topic><topic>Laboratories</topic><topic>Leclercia adecarboxylata</topic><topic>Male</topic><topic>Mali</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Morganella morganii</topic><topic>Morganella morganii - drug effects</topic><topic>Morganella morganii - physiology</topic><topic>Nosocomial infections</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Proteus mirabilis</topic><topic>Salmonella</topic><topic>Salmonella enteritidis</topic><topic>Teaching hospitals</topic><topic>Young Adult</topic><topic>β Lactamase</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sangare, Samba Adama</creatorcontrib><creatorcontrib>Rondinaud, Emilie</creatorcontrib><creatorcontrib>Maataoui, Naouale</creatorcontrib><creatorcontrib>Maiga, Almoustapha Issiaka</creatorcontrib><creatorcontrib>Guindo, Ibrehima</creatorcontrib><creatorcontrib>Maiga, Aminata</creatorcontrib><creatorcontrib>Camara, Namory</creatorcontrib><creatorcontrib>Dicko, Oumar Agaly</creatorcontrib><creatorcontrib>Dao, Sounkalo</creatorcontrib><creatorcontrib>Diallo, Souleymane</creatorcontrib><creatorcontrib>Bougoudogo, Flabou</creatorcontrib><creatorcontrib>Andremont, Antoine</creatorcontrib><creatorcontrib>Maiga, Ibrahim Izetiegouma</creatorcontrib><creatorcontrib>Armand-Lefevre, Laurence</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale in Context : Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>ProQuest Biological Science Journals</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sangare, Samba Adama</au><au>Rondinaud, Emilie</au><au>Maataoui, Naouale</au><au>Maiga, Almoustapha Issiaka</au><au>Guindo, Ibrehima</au><au>Maiga, Aminata</au><au>Camara, Namory</au><au>Dicko, Oumar Agaly</au><au>Dao, Sounkalo</au><au>Diallo, Souleymane</au><au>Bougoudogo, Flabou</au><au>Andremont, Antoine</au><au>Maiga, Ibrahim Izetiegouma</au><au>Armand-Lefevre, Laurence</au><au>Gonzalez-Bello, Concepción</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Very high prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae in bacteriemic patients hospitalized in teaching hospitals in Bamako, Mali</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-02-28</date><risdate>2017</risdate><volume>12</volume><issue>2</issue><spage>e0172652</spage><epage>e0172652</epage><pages>e0172652-e0172652</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The worldwide dissemination of extended-spectrum beta-lactamase producing Enterobacteriaceae, (ESBL-E) and their subset producing carbapenemases (CPE), is alarming. Limited data on the prevalence of such strains in infections from patients from Sub-Saharan Africa are currently available. We determined, here, the prevalence of ESBL-E/CPE in bacteriemic patients in two teaching hospitals from Bamako (Mali), which are at the top of the health care pyramid in the country. During one year, all Enterobacteriaceae isolated from bloodstream infections (E-BSI), were collected from patients hospitalized at the Point G University Teaching Hospital and the pediatric units of Gabriel Touré University Teaching Hospital. Antibiotic susceptibility testing, enzyme characterization and strain relatedness were determined. A total of 77 patients had an E-BSI and as many as 48 (62.3%) were infected with an ESBL-E. ESBL-E BSI were associated with a previous hospitalization (OR 3.97 95% IC [1.32; 13.21]) and were more frequent in hospital-acquired episodes (OR 3.66 95% IC [1.07; 13.38]). Among the 82 isolated Enterobacteriaceae, 58.5% were ESBL-E (20/31 Escherichia coli, 20/26 Klebsiella pneumoniae and 8/15 Enterobacter cloacae). The remaining (5 Salmonella Enteritidis, 3 Morganella morganii 1 Proteus mirabilis and 1 Leclercia adecarboxylata) were ESBL negative. CTX-M-1 group enzymes were highly prevalent (89.6%) among ESBLs; the remaining ones being SHV. One E. coli produced an OXA-181 carbapenemase, which is the first CPE described in Mali. The analysis of ESBL-E relatedness suggested a high rate of cross transmission between patients. In conclusion, even if CPE are still rare for the moment, the high rate of ESBL-BSI and frequent cross transmission probably impose a high medical and economic burden to Malian hospitals.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28245252</pmid><doi>10.1371/journal.pone.0172652</doi><tpages>e0172652</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2017-02, Vol.12 (2), p.e0172652-e0172652 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1872789959 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adolescent Adult Aged Aged, 80 and over Anti-Bacterial Agents - pharmacology Antibiotics Bacteremia - microbiology Bacterial infections Bacteriology Bernard, Claude (1813-1878) Beta lactamases beta-Lactamases - metabolism Biology and Life Sciences Carbapenemase Drug Resistance, Bacterial E coli Enterobacter cloacae Enterobacter cloacae - drug effects Enterobacter cloacae - physiology Enterobacteriaceae Enterobacteriaceae - drug effects Enterobacteriaceae - enzymology Enterobacteriaceae - isolation & purification Enterobacteriaceae - physiology Enzymes Escherichia coli Escherichia coli - drug effects Escherichia coli - physiology Female Genetic aspects Health aspects Health care Hospital patients Hospitalization Hospitals Hospitals, Teaching - statistics & numerical data Humans Infections Klebsiella Klebsiella pneumoniae Klebsiella pneumoniae - drug effects Klebsiella pneumoniae - physiology Laboratories Leclercia adecarboxylata Male Mali Medicine and Health Sciences Middle Aged Morganella morganii Morganella morganii - drug effects Morganella morganii - physiology Nosocomial infections Patients Pediatrics Prevalence Prospective Studies Proteus mirabilis Salmonella Salmonella enteritidis Teaching hospitals Young Adult β Lactamase |
| title | Very high prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae in bacteriemic patients hospitalized in teaching hospitals in Bamako, Mali |
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