Gastrointestinal colonization of extended-spectrum beta-lactamase-producing bacteria among children below five years of age hospitalized with fever in Dar es Salaam, Tanzania
Objectives: Gastrointestinal colonization of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) is of concern because prior colonization increases risk for subsequent infections. To date, the link between ESBL-PE faecal carriage and the risk of subsequent ESBL-PE infection has not...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | Journal of Global Antimicrobial Resistance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716522001291 |
| _version_ | 1818479338555703296 |
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| author | Upendo O. Kibwana Joel Manyahi Helene Heitmann Sandnes Bjørn Blomberg Stephen E. Mshana Nina Langeland Sabrina J. Moyo |
| author_facet | Upendo O. Kibwana Joel Manyahi Helene Heitmann Sandnes Bjørn Blomberg Stephen E. Mshana Nina Langeland Sabrina J. Moyo |
| author_sort | Upendo O. Kibwana |
| collection | DOAJ |
| description | Objectives: Gastrointestinal colonization of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) is of concern because prior colonization increases risk for subsequent infections. To date, the link between ESBL-PE faecal carriage and the risk of subsequent ESBL-PE infection has not been well established, and information on carriage of such pathogens among children with invasive infections such as bloodstream infections (BSI) remains to be explored worldwide. Methods: This cross-sectional study was conducted among children under the age of 5 years admitted for febrile illness in Dar es Salaam, Tanzania, between March 2017 and July 2018. We used rectal swabs to screen for ESBL-PE using selective media, ChromID ESBL. Bacterial isolates were identified by MALDI-TOF. Blood cultures were drawn from all children. Antimicrobial susceptibility testing was done using a disk diffusion method. ESBL alleles were identified by real-time PCR and sequencing. Results: The overall prevalence of ESBL-PE carriage was 56% (112/200) and was highest among children 4 to 6 months old (17/21, 81%) (P = 0.05). Children with BSI had high ESBL-PE carriage (78.4%) compared to those without BSI (53.1%) (P = 0.02; aOR 3.4, 95% confidence interval 1.20–9.58). The most common isolate was E. coli (64/112, 45%). Sixteen pairs of ESBL-PE isolates (from the gut and from blood) had a similar antimicrobial susceptibility profile. We detected blaCTX-M gene in 97% of all phenotypically detected ESBL-PE; among those, blaCTX-M-15 was dominant (99%). Conclusion: We report a high prevalence of ESBL-PE faecal carriage among children with BSI in Tanzania. Colonization of ESBL-PE was a risk factor for ESBL-BSI. |
| first_indexed | 2024-12-10T11:09:17Z |
| format | Article |
| id | doaj.art-f03d847e0f584d1198831fe0229e00f5 |
| institution | Directory Open Access Journal |
| issn | 2213-7165 |
| language | English |
| last_indexed | 2024-12-10T11:09:17Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj.art-f03d847e0f584d1198831fe0229e00f52022-12-22T01:51:29ZengElsevierJournal of Global Antimicrobial Resistance2213-71652022-09-0130107114Gastrointestinal colonization of extended-spectrum beta-lactamase-producing bacteria among children below five years of age hospitalized with fever in Dar es Salaam, TanzaniaUpendo O. Kibwana0Joel Manyahi1Helene Heitmann Sandnes2Bjørn Blomberg3Stephen E. Mshana4Nina Langeland5Sabrina J. Moyo6Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; Corresponding author: Muhimbili University of Health and Allied Sciences P.O box 65001 Dar es Salaam, Tanzania.Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; Department of Clinical Science, University of Bergen, Bergen, NorwayDepartment of Clinical Science, University of Bergen, Bergen, NorwayDepartment of Clinical Science, University of Bergen, Bergen, Norway; Norwegian National Advisory Unit on Tropical Infectious Diseases, Haukeland University Hospital, Bergen, NorwayDepartment of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, TanzaniaDepartment of Clinical Science, University of Bergen, Bergen, Norway; Norwegian National Advisory Unit on Tropical Infectious Diseases, Haukeland University Hospital, Bergen, NorwayDepartment of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; Norwegian National Advisory Unit on Tropical Infectious Diseases, Haukeland University Hospital, Bergen, NorwayObjectives: Gastrointestinal colonization of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) is of concern because prior colonization increases risk for subsequent infections. To date, the link between ESBL-PE faecal carriage and the risk of subsequent ESBL-PE infection has not been well established, and information on carriage of such pathogens among children with invasive infections such as bloodstream infections (BSI) remains to be explored worldwide. Methods: This cross-sectional study was conducted among children under the age of 5 years admitted for febrile illness in Dar es Salaam, Tanzania, between March 2017 and July 2018. We used rectal swabs to screen for ESBL-PE using selective media, ChromID ESBL. Bacterial isolates were identified by MALDI-TOF. Blood cultures were drawn from all children. Antimicrobial susceptibility testing was done using a disk diffusion method. ESBL alleles were identified by real-time PCR and sequencing. Results: The overall prevalence of ESBL-PE carriage was 56% (112/200) and was highest among children 4 to 6 months old (17/21, 81%) (P = 0.05). Children with BSI had high ESBL-PE carriage (78.4%) compared to those without BSI (53.1%) (P = 0.02; aOR 3.4, 95% confidence interval 1.20–9.58). The most common isolate was E. coli (64/112, 45%). Sixteen pairs of ESBL-PE isolates (from the gut and from blood) had a similar antimicrobial susceptibility profile. We detected blaCTX-M gene in 97% of all phenotypically detected ESBL-PE; among those, blaCTX-M-15 was dominant (99%). Conclusion: We report a high prevalence of ESBL-PE faecal carriage among children with BSI in Tanzania. Colonization of ESBL-PE was a risk factor for ESBL-BSI.http://www.sciencedirect.com/science/article/pii/S2213716522001291ESBL-producing EnterobacteriaceaeBloodstream infectionFaecal carriage |
| spellingShingle | Upendo O. Kibwana Joel Manyahi Helene Heitmann Sandnes Bjørn Blomberg Stephen E. Mshana Nina Langeland Sabrina J. Moyo Gastrointestinal colonization of extended-spectrum beta-lactamase-producing bacteria among children below five years of age hospitalized with fever in Dar es Salaam, Tanzania Journal of Global Antimicrobial Resistance ESBL-producing Enterobacteriaceae Bloodstream infection Faecal carriage |
| title | Gastrointestinal colonization of extended-spectrum beta-lactamase-producing bacteria among children below five years of age hospitalized with fever in Dar es Salaam, Tanzania |
| title_full | Gastrointestinal colonization of extended-spectrum beta-lactamase-producing bacteria among children below five years of age hospitalized with fever in Dar es Salaam, Tanzania |
| title_fullStr | Gastrointestinal colonization of extended-spectrum beta-lactamase-producing bacteria among children below five years of age hospitalized with fever in Dar es Salaam, Tanzania |
| title_full_unstemmed | Gastrointestinal colonization of extended-spectrum beta-lactamase-producing bacteria among children below five years of age hospitalized with fever in Dar es Salaam, Tanzania |
| title_short | Gastrointestinal colonization of extended-spectrum beta-lactamase-producing bacteria among children below five years of age hospitalized with fever in Dar es Salaam, Tanzania |
| title_sort | gastrointestinal colonization of extended spectrum beta lactamase producing bacteria among children below five years of age hospitalized with fever in dar es salaam tanzania |
| topic | ESBL-producing Enterobacteriaceae Bloodstream infection Faecal carriage |
| url | http://www.sciencedirect.com/science/article/pii/S2213716522001291 |
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