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Multicountry distribution and characterization of extended-spectrum β-lactamase-associated gram-negative bacteria from bloodstream infections in sub-Saharan Africa

Toy, Trevor and Pak, Gi Deok and Duc, Trung Pham and Campbell, James I. and El Tayeb, Muna Ahmed and Von Kalckreuth, Vera and Im, Justin and Panzner, Ursula and Cruz Espinoza, Ligia Maria and Eibach, Daniel and Dekker, Denise Myriam and Park, Se Eun and Jeon, Hyon Jin and Konings, Frank and Mogeni, Ondari D. and Cosmas, Leonard and Bjerregaard-Andersen, Morten and Gasmelseed, Nagla and Hertz, Julian T. and Jaeger, Anna and Krumkamp, Ralf and Ley, Benedikt and Thriemer, Kamala and Kabore, Leon Parfait and Niang, Aissatou and Raminosoa, Tiana Mirana and Sampo, Emmanuel and Sarpong, Nimako and Soura, Abdramane and Owusu-Dabo, Ellis and Teferi, Mekonnen and Yeshitela, Biruk and Poppert, Sven and May, Jürgen and Kim, Jerome H. and Chon, Yun and Park, Jin Kyung and Aseffa, Abroaham and Breiman, Robert F. and Schütt-Gerowitt, Heidi and Aaby, Peter and Adu-Sarkodie, Yaw and Crump, John A. and Rakotozandrindrainy, Raphaël and Meyer, Christian G. and Sow, Amy Gassama and Clemens, John D. and Wierzba, Thomas F. and Baker, Stephen and Marks, Florian. (2019) Multicountry distribution and characterization of extended-spectrum β-lactamase-associated gram-negative bacteria from bloodstream infections in sub-Saharan Africa. Clinical Infectious Diseases, 69 (Suppl. 6). S449-S458.

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Abstract

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.; 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.; 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.; 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.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
UniBasel Contributors:Panzner, Ursula and Poppert, Sven
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Oxford University Press
ISSN:1058-4838
e-ISSN:1537-6591
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:05 Mar 2020 09:43
Deposited On:05 Mar 2020 09:43

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