Molecular characterization of invasive Enterobacteriaceae from pediatric patients in Central and Northwestern Nigeria

被引：14

作者：

Duru, Carissa ^{[1
]}

Olanipekun, Grace ^{[1
]}

Odili, Vivian ^{[1
]}

Kocmich, Nicholas ^{[2
]}

Rezac, Amy ^{[2
]}

Ajose, Theresa O. ^{[1
]}

Medugu, Nubwa ^{[3
]}

Umoru, Dominic ^{[4
]}

Onuchukwu, Chukwuma ^{[5
]}

Munir, Huda ^{[6
]}

Jibir, Binta Wudil ^{[7
]}

Farouk, Zubaida ^{[6
]}

Gambo, Safiya ^{[8
]}

Hassan-Hanga, Fatimah ^{[6
]}

Olaosebikan, Rasaq ^{[1
]}

Ebruke, Bernard ^{[1
]}

Esimone, Charles ^{[9
]}

Obaro, Stephen ^{[2
]}

机构：

[1] Int Fdn Infect Dis Nigeria, Abuja, Nigeria

[2] Univ Nebraska Med Ctr, Dept Pediat Infect Dis, Omaha, NE 68198 USA

[3] Int Fdn Infect Dis Nigeria, Natl Hosp Abuja, Dept Med Microbiol & Parasitol, Abuja, Nigeria

[4] Maitama Dist Hosp, Abuja, Nigeria

[5] Fed Med Ctr, Keffi, Nigeria

[6] Aminu Kano Teaching Hosp, Kano, Nigeria

[7] Hasiya Bayero Paediat Hosp, Kano, Nigeria

[8] Murtala Muhammed Specialist Hosp, Kano, Nigeria

[9] Nnamdi Azikiwe Univ, Awka, Nigeria

来源：

PLOS ONE | 2020年 / 15卷 / 10期

基金：

比尔及梅琳达.盖茨基金会; 美国国家卫生研究院;

关键词：

SPECTRUM-BETA-LACTAMASE; COMMENSAL ESCHERICHIA-COLI; ANTIBIOTIC-RESISTANCE; KLEBSIELLA-PNEUMONIAE; PREVALENCE; CTX-M-15; CHILDREN; GENES; LAGOS;

D O I：

10.1371/journal.pone.0230037

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Background Bacteremia is a leading cause of mortality in developing countries, however, etiologic evaluation is infrequent and empiric antibiotic use not evidence-based. Here, we evaluated the patterns of ESBL resistance in children enrolled into a surveillance study for community acquired bacteremic syndromes across health facilities in Central and Northwestern Nigeria. Method Blood culture was performed for children aged less than 5 years suspected of having sepsis from Sept 2008-Dec 2016. Blood was incubated using the BACTEC(00AE) system and Enterobacteriacea identified to the species level using Analytical Profile Index (API20E(R)). Antibiotic susceptibility profile was determined by the disc diffusion method. Real time PCR was used to characterize genes responsible for ESBL production. Result Of 21,000 children screened from Sept 2008-Dec 2016, 2,625(12.5%) were culture-positive. A total of 413 Enterobacteriaceae available for analysis were screened for ESBL. ESBL production was detected in 160 Enterobacteriaceae, high resistance rates were observed among ESBL-positive isolates for Ceftriaxone (92.3%), Aztreonam (96.8%), Cefpodoxime (96.3%), Cefotaxime (98.8%) and Trimethoprim/sulfamethoxazole (90%), while 87.5%, 90.7%, and 91.9% of the isolates were susceptible to Imipenem, Amikacin and Meropenem respectively. Frequently detected resistance genes were blaTEM-83.8% (134/160), and, blaCTX-M 83.1% (133/160) followed by blaSHVgenes 66.3% (106/160). Co-existence of blaCTX-M, blaTEM and blaSHV was seen in 94/160 (58.8%), blaCTX-M and blaTEM in 118/160 (73.8%), blaTEM and blaSHV in 97/160 (60.6%) and blaCTX-M and blaSHV in 100/160 (62.5%) of isolates tested. Conclusion Our results indicate a high prevalence of bacteremia from ESBL Enterobacteriaceae in this population of children. These are resistant to commonly used antibiotics and careful choice of antibiotic treatment options is critical. Further studies to evaluate transmission dynamics of resistance genes could help in the reduction of ESBL resistance in these settings.

引用

页数：11

共 46 条

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