Antimicrobial resistance trends in clinical Escherichia coli and Klebsiella pneumoniae in Ethiopia
Background: Clinicians rely on local antimicrobial resistance pattern data to guide empiric treatment for seriously ill patients when culture and antimicrobial susceptibility testing results are not immediately available. Objective: This study aimed to analyse 5-year trends in antimicrobial resista...
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| Format: | Article |
| Language: | English |
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AOSIS
2024-03-01
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| Series: | African Journal of Laboratory Medicine |
| Subjects: | |
| Online Access: | https://ajlmonline.org/index.php/ajlm/article/view/2268 |
| _version_ | 1797223649288126464 |
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| author | Abera A. Kitaba Zelalem T. Bonger Degefu Beyene Zeleke Ayenew Estifanos Tsige Tesfa Addis Kefale Yonas Mekonnen Dejenie S. Teklu Elias Seyoum Abebe A. Negeri |
| author_facet | Abera A. Kitaba Zelalem T. Bonger Degefu Beyene Zeleke Ayenew Estifanos Tsige Tesfa Addis Kefale Yonas Mekonnen Dejenie S. Teklu Elias Seyoum Abebe A. Negeri |
| author_sort | Abera A. Kitaba |
| collection | DOAJ |
| description | Background: Clinicians rely on local antimicrobial resistance pattern data to guide empiric treatment for seriously ill patients when culture and antimicrobial susceptibility testing results are not immediately available.
Objective: This study aimed to analyse 5-year trends in antimicrobial resistance profiles of Escherichia coli and Klebsiella pneumoniae isolates.
Methods: Bacteriology reports from 2017 to 2021 at the Ethiopian Public Health Institute were analysed retrospectively. Isolates were identified using either the VITEK 2 Compact system, the BD Phoenix M50 instrument, or conventional biochemical tests. Antimicrobial susceptibility testing was conducted using either the Kirby-Bauer disk diffusion method or the VITEK 2 Compact system and BD Phoenix M50 systems available at the time of testing. The Cochran Armitage trend test was employed to test the significance of antimicrobial resistance trends over time. P-values less than 0.05 were considered statistically significant.
Results: Of the 5382 bacteriology reports examined, 458 (9%) were on E. coli and 266 (5%) were on K. pneumoniae. Both K. pneumoniae (88%) and E. coli (65%) demonstrated high resistance to extended-spectrum cephalosporins. However, both K. pneumoniae (14%) and E. coli (5%) showed lower rates of resistance to carbapenems compared to other antimicrobials. In K. pneumoniae, resistance to carbapenems (from 0% to 38%; p 0.001) and ciprofloxacin (from 41% to 90%; p 0.001) increased significantly between 2017 and 2021.
Conclusion: Both organisms showed very high resistance to broad-spectrum antibiotics. Additionally, K. pneumoniae demonstrated a statistically significant rise in ciprofloxacin and carbapenem resistance.
What this study adds: This study emphasises the significance of regular reporting of local antimicrobial resistance patterns as this information can guide appropriate empiric therapy and efforts to address antimicrobial resistance issues. |
| first_indexed | 2024-04-24T13:40:35Z |
| format | Article |
| id | doaj.art-4325f672a3e649119e9a2e6cb9c701b6 |
| institution | Directory Open Access Journal |
| issn | 2225-2002 2225-2010 |
| language | English |
| last_indexed | 2024-04-24T13:40:35Z |
| publishDate | 2024-03-01 |
| publisher | AOSIS |
| record_format | Article |
| series | African Journal of Laboratory Medicine |
| spelling | doaj.art-4325f672a3e649119e9a2e6cb9c701b62024-04-04T08:41:47ZengAOSISAfrican Journal of Laboratory Medicine2225-20022225-20102024-03-01131e1e710.4102/ajlm.v13i1.2268462Antimicrobial resistance trends in clinical Escherichia coli and Klebsiella pneumoniae in EthiopiaAbera A. Kitaba0Zelalem T. Bonger1Degefu Beyene2Zeleke Ayenew3Estifanos Tsige4Tesfa Addis Kefale5Yonas Mekonnen6Dejenie S. Teklu7Elias Seyoum8Abebe A. Negeri9National Clinical Bacteriology and Mycology Reference Laboratory, Ethiopian Public Health Institute, Addis AbabaNational Clinical Bacteriology and Mycology Reference Laboratory, Ethiopian Public Health Institute, Addis AbabaNational Clinical Bacteriology and Mycology Reference Laboratory, Ethiopian Public Health Institute, Addis AbabaNational Clinical Bacteriology and Mycology Reference Laboratory, Ethiopian Public Health Institute, Addis AbabaNational Clinical Bacteriology and Mycology Reference Laboratory, Ethiopian Public Health Institute, Addis AbabaNational Clinical Bacteriology and Mycology Reference Laboratory, Ethiopian Public Health Institute, Addis AbabaNational Clinical Bacteriology and Mycology Reference Laboratory, Ethiopian Public Health Institute, Addis AbabaNational Clinical Bacteriology and Mycology Reference Laboratory, Ethiopian Public Health Institute, Addis AbabaNational Clinical Bacteriology and Mycology Reference Laboratory, Ethiopian Public Health Institute, Addis AbabaNational Clinical Bacteriology and Mycology Reference Laboratory, Ethiopian Public Health Institute, Addis AbabaBackground: Clinicians rely on local antimicrobial resistance pattern data to guide empiric treatment for seriously ill patients when culture and antimicrobial susceptibility testing results are not immediately available. Objective: This study aimed to analyse 5-year trends in antimicrobial resistance profiles of Escherichia coli and Klebsiella pneumoniae isolates. Methods: Bacteriology reports from 2017 to 2021 at the Ethiopian Public Health Institute were analysed retrospectively. Isolates were identified using either the VITEK 2 Compact system, the BD Phoenix M50 instrument, or conventional biochemical tests. Antimicrobial susceptibility testing was conducted using either the Kirby-Bauer disk diffusion method or the VITEK 2 Compact system and BD Phoenix M50 systems available at the time of testing. The Cochran Armitage trend test was employed to test the significance of antimicrobial resistance trends over time. P-values less than 0.05 were considered statistically significant. Results: Of the 5382 bacteriology reports examined, 458 (9%) were on E. coli and 266 (5%) were on K. pneumoniae. Both K. pneumoniae (88%) and E. coli (65%) demonstrated high resistance to extended-spectrum cephalosporins. However, both K. pneumoniae (14%) and E. coli (5%) showed lower rates of resistance to carbapenems compared to other antimicrobials. In K. pneumoniae, resistance to carbapenems (from 0% to 38%; p 0.001) and ciprofloxacin (from 41% to 90%; p 0.001) increased significantly between 2017 and 2021. Conclusion: Both organisms showed very high resistance to broad-spectrum antibiotics. Additionally, K. pneumoniae demonstrated a statistically significant rise in ciprofloxacin and carbapenem resistance. What this study adds: This study emphasises the significance of regular reporting of local antimicrobial resistance patterns as this information can guide appropriate empiric therapy and efforts to address antimicrobial resistance issues.https://ajlmonline.org/index.php/ajlm/article/view/2268antimicrobial resistanceretrospective analysistrend analysisescherichia coliklebsiella pneumoniaeethiopian public health instituteethiopia. |
| spellingShingle | Abera A. Kitaba Zelalem T. Bonger Degefu Beyene Zeleke Ayenew Estifanos Tsige Tesfa Addis Kefale Yonas Mekonnen Dejenie S. Teklu Elias Seyoum Abebe A. Negeri Antimicrobial resistance trends in clinical Escherichia coli and Klebsiella pneumoniae in Ethiopia African Journal of Laboratory Medicine antimicrobial resistance retrospective analysis trend analysis escherichia coli klebsiella pneumoniae ethiopian public health institute ethiopia. |
| title | Antimicrobial resistance trends in clinical Escherichia coli and Klebsiella pneumoniae in Ethiopia |
| title_full | Antimicrobial resistance trends in clinical Escherichia coli and Klebsiella pneumoniae in Ethiopia |
| title_fullStr | Antimicrobial resistance trends in clinical Escherichia coli and Klebsiella pneumoniae in Ethiopia |
| title_full_unstemmed | Antimicrobial resistance trends in clinical Escherichia coli and Klebsiella pneumoniae in Ethiopia |
| title_short | Antimicrobial resistance trends in clinical Escherichia coli and Klebsiella pneumoniae in Ethiopia |
| title_sort | antimicrobial resistance trends in clinical escherichia coli and klebsiella pneumoniae in ethiopia |
| topic | antimicrobial resistance retrospective analysis trend analysis escherichia coli klebsiella pneumoniae ethiopian public health institute ethiopia. |
| url | https://ajlmonline.org/index.php/ajlm/article/view/2268 |
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