Journal article
Prevalence and risk factors for CTX-M gram-negative bacteria in hospitalized patients at a tertiary care hospital in Kilimanjaro, Tanzania
Kilimanjaro Christian Medical Centre1
Kilimanjaro Christian Medical University College2
University of Copenhagen3
Department of Bio and Health Informatics, Technical University of Denmark4
Genomic Epidemiology, Department of Bio and Health Informatics, Technical University of Denmark5
National Food Institute, Technical University of Denmark6
Research Group for Genomic Epidemiology, National Food Institute, Technical University of Denmark7
East African Health Research Commission8
Emergence and spread of extended spectrum beta-lactamase (ESBL)-producing gram-negative bacteria, mainly due to CTX-M, is a major global public health problem. Patients infected with ESBL-producing gram-negative bacteria have an increased risk of treatment failure and death. We investigated the prevalence and risk factors for CTX-M gram-negative bacteria isolated from clinical specimens of patients hospitalized at a tertiary care hospital in Kilimanjaro, Tanzania.
Isolated gram-negative bacteria from inpatients admitted at Kilimanjaro Christian Medical Centre (KCMC) between August 2013 and August 2015 were fully genome sequenced. The prevalence of ESBL-producing gram-negative bacteria was determined based on the presence of blaCTX-M. The odds ratio (OR) and risk factors for ESBL-producing gram-negative bacteria due to CTX-M were assessed using logistic regression models.
The overall CTX-M prevalence (95% CI) was 13.6% (10.1–18.1). Adjusted for other factors, the OR of CTX-M gram-negative bacteria for patients previously hospitalized was 0.26 (0.08–0.88), p = 0.031; the OR for patients currently on antibiotics was 4.02 (1.29–12.58), p = 0.017; the OR for patients currently on ceftriaxone was 0.14 (0.04–0.46), p = 0.001; and the OR for patients with wound infections was 0.24 (0.09–0.61), p = 0.003.
The prevalence of ESBL-producing gram-negative bacteria due to CTX-M in this setting is relatively low compared to other previous reports in similar settings. However, to properly stop further spread in the hospital, we recommend setting up a hospital surveillance system that takes full advantage of the available next-generation sequencing facility to routinely screen for all types of bacterial resistance genes.
Language: | English |
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Publisher: | Springer Berlin Heidelberg |
Year: | 2018 |
Pages: | 897-906 |
ISSN: | 14354373 and 09349723 |
Types: | Journal article |
DOI: | 10.1007/s10096-018-3196-8 |
ORCIDs: | 0000-0002-3835-3333 , Lund, Ole and Møller Aarestrup, Frank |
CTX-M ESBL Gram-negative bacteria Prevalence SDG 3 - Good Health and Well-being Tanzania Whole genome sequencing
Adult Biomedical and Life Sciences Biomedicine Comorbidity Cross Infection Cross-Sectional Studies Female Genome, Bacterial Gram-Negative Bacteria Gram-Negative Bacterial Infections Humans Internal Medicine Male Medical Microbiology Middle Aged Public Health Surveillance Risk Factors Tertiary Care Centers Whole Genome Sequencing beta-Lactam Resistance beta-Lactamases