| Title: |
Multicountry distribution and characterization of extended-spectrum β-lactamase-associated gram-negative bacteria from bloodstream infections in sub-Saharan Africa |
| Authors: |
Toy, T; Pak, GD; Duc, TP; Campbell, JI; El Tayeb, MA; Von Kalckreuth, V; Im, J; Panzner, U; Cruz Espinoza, LM; Eibach, D; Dekker, DM; Park, SE; Jeon, HJ; Konings, F; Mogeni, OD; Cosmas, L; Bjerregaard-Andersen, M; Gasmelseed, N; Hertz, JT; Jaeger, A; Krumkamp, R; Ley, B; Thriemer, K; Kabore, LP; Niang, A; Raminosoa, TM; Sampo, E; Sarpong, N; Soura, A; Owusu-Dabo, E; Teferi, M; Yeshitela, B; Poppert, S; May, J; Kim, JH; Chon, Y; Park, JK; Aseffa, A; Breiman, RF; Schütt-Gerowitt, H; Aaby, P; Adu-Sarkodie, Y; Crump, JA; Rakotozandrindrainy, R; Meyer, CG; Sow, AG; Clemens, JD; Wierzba, TF; Baker, S; Marks, F |
| Publisher Information: |
Oxford University Press |
| Publication Year: |
2020 |
| Collection: |
Oxford University Research Archive (ORA) |
| Description: |
Background Antimicrobial resistance (AMR) is a major global health concern, yet, there are noticeable gaps in AMR surveillance data in regions such as sub-Saharan Africa. We aimed to measure the prevalence of extended-spectrum β-lactamase (ESBL) producing Gram-negative bacteria in bloodstream infections from 12 sentinel sites in sub-Saharan Africa. Methods Data were generated during the Typhoid Fever Surveillance in Africa Program (TSAP), in which standardized blood cultures were performed on febrile patients attending 12 health facilities in 9 sub-Saharan African countries between 2010 and 2014. Pathogenic bloodstream isolates were identified at the sites and then subsequently confirmed at a central reference laboratory. Antimicrobial susceptibility testing, detection of ESBL production, and conventional multiplex polymerase chain reaction (PCR) testing for genes encoding for β-lactamase were performed on all pathogens. Results Five hundred and five pathogenic Gram-negative bloodstream isolates were isolated during the study period and available for further characterization. This included 423 Enterobacteriaceae. Phenotypically, 61 (12.1%) isolates exhibited ESBL activity, and genotypically, 47 (9.3%) yielded a PCR amplicon for at least one of the screened ESBL genes. Among specific Gram-negative isolates, 40 (45.5%) of 88 Klebsiella spp., 7 (5.7%) of 122 Escherichia coli, 6 (16.2%) of 37 Acinetobacter spp., and 2 (1.3%) of 159 of nontyphoidal Salmonella (NTS) showed phenotypic ESBL activity. Conclusions Our findings confirm the presence of ESBL production among pathogens causing bloodstream infections in sub-Saharan Africa. With few alternatives for managing ESBL-producing pathogens in the African setting, measures to control the development and proliferation of AMR organisms are urgently needed. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://doi.org/10.1093/cid/ciz450 |
| DOI: |
10.1093/cid/ciz450 |
| Availability: |
https://doi.org/10.1093/cid/ciz450; https://ora.ox.ac.uk/objects/uuid:65ad792b-e849-42ff-af4f-9253399da044 |
| Rights: |
info:eu-repo/semantics/openAccess ; CC Attribution (CC BY) |
| Accession Number: |
edsbas.99CBD02C |
| Database: |
BASE |