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Characterization of Extended Spectrum Beta-lactamase and Carbapenamase Producing Enterobacteriaceae Causing Urinary Tract Infection among Children in Kenya: A Cross-Sectional Study

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Advances in Microbiology 2024年第7期14卷 351-365页

作者： Rachael Wangeci Waithaka Janet Kerubo Maranga celestine Khalechi makobe Department of Microbiology Jomo Kenyatta University of Agriculture and Technology Juja Kenya Gertrudes Childrens Hospital Nairobi Kenya

Introduction: Enterobacteriaceae causing urinary tract infections (UTI) have developed resistance to the commonly used antibiotics due to emergence of Extended Spectrum Beta-Lactamases (ESBLs) and Carbapenamase producing Enterobactericeae which are a public health problem worldwide. This study aims to determine the prevalence and characterize ESBLs and carbapenamase producing Enterobactericeae. Method: A cross-sectional study was carried out in Gertrude’s Children’s Hospital, Nairobi. 238 urine samples were collected from patients with urinary symptoms attending the outpatient department within the period 2020-2021. The urine were examined macroscopically and microscopically. Identification and antimicrobial susceptibility testing were done using VITEK® 2 Compact system (BioMérieux). Double disc synergy test and modified hodge tests were done as confirmatory tests for ESBLs and Carbapenamase phenotypes respectively. Polymerase Chain Reaction was used for the detection of blaCTX-M, blaTEM, blaSHV, blaKPC and blaOXA-48 genes. Results: From the 238 children sampled the prevalence of UTI caused by Enterobactericeae was 22.3%. The Enterobacteriaceae species isolated were Escherichia coli (84.9%), Klebsiella pneumoniae (5.66%), Proteus mirabillis (5.66%), Enterobacter aerogenes (1.89%) and Morganella morganii (1.89%). The isolated species were resistant to ampicillin. Meropenem had the highest susceptibility. Only E. coli species had the ESBLs (26.4%) and carbapenamase (1.9%) phenotypes. 100% had BlaCTX-M while 50% had blaTEM resistant gene. There was a significant association (p Conclusion: Ampicillin resistance resulted to use of alternative drugs and Meropenem was the drug of choice where increased resistance to the recommended drugs was noted. Further research on resistant genes is recommended.

关键词： Enterobactericeae Urinary Tract Infection Prevalence Beta Lactamases Polymerase Chain Reaction Children Outpatient Antimicrobial Resistance Phenotypes Escherichia coli

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Phenotypic and Genotypic Characterization of Extended Spectrum Beta-Lactamases Producing Bacteria Causing Urinary Tract Infections among Expectant Women Attending Antenatal Clinic at Ruiru Sub County Hospital, Kenya

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Advances in Microbiology 2023年第12期13卷 571-587页

作者： Eunice Maingi Andrew Nyerere celestine makobe Department of Medical Microbiology College of Health Science Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya

Background: Urinary tract infection (UTI) is a bacterial infection affecting males and females but is more prevalent in expectant women. ESBLs are bacteria with enzymes that make them resistant to many antibiotics, posing a significant health challenge. This study aims to determine the characteristics of ESBL-producing bacteria causing UTIs in expectant women. Methodology: A self-administered survey was carried out;300 expectant women were recruited using a random sampling method. A questionnaire was used to collect socio-demographic information. Urine samples were collected in sterile universal bottles and processed at the JKUAT Zoology laboratory. Urine samples were analyzed using urinalysis, microscopy, culture, and sensitivity testing. ESBL-producing bacteria were identified phenotypically using the double-disc synergy test (DDST) and genotyped for specific resistant genes using PCR. Results: UTI prevalence was 32.7% (98/300). UTI was significantly associated with the history of previous UTI (OR = 0.84, p = 0.02) and multigravida (OR = 0.14 p = 0.01). UTI was common in women aged between 28-37 years in their second trimester. Bacteria isolated were E. coli 57.1% (56/98), S. aureus 21.4% (21/98) K. pneumonia 11.2% (11/98) and Proteus spp 10.4% (10/98). Bacteria antibiotic resistance patterns were E. coli-tetracycline (91.1%), sulfamethoxazole (55.4%), cefotaxime (53.4%) and augmentin (53.4%). S. aureus-sulfamethozaxole (100%) and augmentin (71.4%), K. pneumoniae-sulfame-thoxazole (72.2%) cefotaxime (63.6%), chloramphenicol and tetracycline (54.5%). Proteus spp: tetracycline (100%), nitrofurantoin (90%), cefotaxime and chloramphenicol (50%). The proportion of ESBLs bacterial producers was 37.6% (29/77) and 44.8% (13/29) possessed ESBLs resistant genes;Bla CTX-M 53.8% (7/13), Bla SHV and Bla TEM 23.1% (3/13) each, Bla OXA (0%) was not detected. Conclusion: The study revealed a high proportion of ESBLs producing bacteria responsible for UTI in expectant women. ESBLs

关键词： Urinary Tract Infections Resistant Genes Genotypic Phenotypic Extended Spectrum Beta Lactamases

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Antimicrobial Susceptibility and Genetic Basis of Resistance of <i>Klebsiella spp</i>Isolated from Diarrheic and Non-Diarrheic Children at Health Facilities in Mukuru Informal Settlement, Nairobi, Kenya

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Advances in Microbiology 2021年第10期11卷 554-578页

作者： celestine Wanjiku Wairimu Eddy Okoth Odari celestine Khalechi makobe Samuel Kariuki Department of Medical Microbiology College of health Science Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya Centre for Microbiology Research Kenya Medical Research Institute Nairobi Kenya

Antimicrobial resistance (AMR) is a global threat to public health and particularly to children. This study aimed to determine the prevalence of multidrug resistance of fecal Klebsiella spp on selected beta lactam (3rd generation cephalosporins and carbapenems) and fluoroquinolone classes of drugs in four health facilities serving the slum communities of Nairobi city in Kenya. Additionally, determine the genetic basis for the multidrug resistance observed. A cross sectional laboratory based study was undertaken where a total of 1171 children below 16 years were selected, from whom stool samples were collected, tested and analyzed. 395 (33.73%) Klebsiella spp were isolated, consisting of 365 (92.4%) Klebsiella pneumoniae and 30 (7.6%) Klebsiella oxytoca were isolated. The proportion of multi-drug resistance (MDR) K. pneumoniae and MDR K. oxytoca was 64.1% (234/365) and 96.67% (29/30) respectively. Third generation cephalosporins, cefotaxime ceftriaxone and ceftazidime showed the highest resistance of 30.7%, 29.9% and 27.4% respectively, whereas carbapenems including imipenem and meropenem had the least resistance of 1.6%, each, to K. pneumoniae. A significant association was observed in diarrheic children (OR = 1.88;p = 0.01) and those below 50 months (OR = 0.43;p = 0.002) and carrying K. pneumoniae resistance to one or more third generation cephalosporins. Genes associated with resistance included bla TEM 100%, bla CTX-M 95.2%, bla SHV 57.1%, bla OXA-1 66.7%, qnrS 54.1%, qnrB 47.6% and bla NDM 7.1%. In conclusion, there’s need for more effective infection control measures, antimicrobial stewardship to reduce emergence of antimicrobial resistance, improved drinking water, sanitation and hygiene (WASH) practices.

关键词： Klebsiella Antimicrobial Resistance Carriage Community Children Slums Kenya

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Prevalence of CTXM, SHV, TEM AND OXA Genes among Extended-Spectrum Beta-Lactamase Producing <i>Klebsiella pneumoniae</i>from Mukuru Slum, Kenya

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Advances in Microbiology 2019年第10期9卷 853-862页

作者： Hellen Saisi celestine makobe Maureen Kangongo Samwuel Kariuki Department of Medical Microbiology College of health Science Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya Centre for Microbiology Research Kenya Medical Research Institute Nairobi Kenya

Background: Extended spectrum beta lactamases (ESBLs) producing Enterobacteriaceae cause infections that are often reported in both hospital and community setting. These infections are on the increase and jeopardize the achievement of modern medicine because of their clinical implications. There is need for surveillance measures to be taken, both by the health care personnel and the community at large. Methodology: We examined 330 diarrhea stool samples from children below the age of 5 years and processed them. A total of 96 (29%) samples were identified as Klebsiella pneumoniae out of the bacteria isolated. Identification of ESBL was done and 42 K. pneumoniae isolates were tested for the occurrence of blaCTX-M, blaOXA, blaTEM and blaSHV resistant genes by PCR, gel electrophoresis and visualized by UV illumination. Results: Our results revealed that blaCTXM was the most frequent ESBL type 42 (100%), followed by blaTEM in 41 (97.6%) isolates and blaSHVin38 (90.4%) of the isolates. None of the tested isolates were found to be encoding blaOXA. There was occurrence of more than one gene in most of the isolates. The double combination was detected in blaCTX-M/blaTEM (9.5%) and blaCTXM/SHV (2.4%). A triple combination was noted blaTEM/blaSHV/bla CTX-M (88%). Conclusion: Our results indicate that there is Presence of Beta lactam genes associated with antimicrobial resistance among the K. pneumoniae isolates from Mukuru Slum, Kenya. The predominant ESBL genotype in Mukuru slums, Kenya was blaCTX-M followed by blaTEM and blaSHV respectively. There is need for surveillance measures to be taken so as to control the spread among the community.

关键词： Klebsiella Pneumoniae Resistant Genes ESBL

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