Asymptomatic Gastrointestinal Carriage of Multidrug-Resistant Carbapenemase-Producing Enterobacteriaceae among Children Under Five Years in a Kenyan Hospital
Loading...
Date
2023-07
Authors
Mutuma, Caroline Kirito
Maingi, John
Maina, Anthony Karoki
Njeru, John
Musyoki, Abednego Moki
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Abstract
Objectives: Asymptomatic gastrointestinal carriage of carbapenem-resistant Enterobacteriaceae (CRE) is a threat
to global health in developing countries with inadequate safe drinking water, poor hygiene, and weak antimicrobial stewardship; however, epidemiological data to guide CRE infection prevention and control is limited in
these settings. We assessed asymptomatic CRE and carbapenem-producing Enterobacteriaceae (CPE) fecal carriage rates and associated risk factors among hospitalized children aged under 5 years.
Methods: We adopted a cross-sectional study at Mama Lucy Kibaki Hospital in Nairobi-City County, Kenya, between June and September 2022. We collected demographic and clinical characteristics using a structured questionnaire and clinical reports and analyzed stool/rectal swab samples by standard and automated bacteriological
methods.
Results: Asymptomatic CRE and CPE fecal carriage rate was 2.25% (6/267), with six isolates recovered, predominated by Escherichia coli (33.33%) and Enterobacter cloacae subsp dissolvens (33.33%). Third-generation
cephalosporin and ciprofloxacin resistance were highest in Citrobacter farmer and E. cloacae subsp cloacae. All
CRE and CPE were multidrug-resistant, and except E. cloacae subsp cloacae, were 100% colistin-resistant.
Conclusions: Asymptomatic gastrointestinal carriage of multidrug-resistant-CRE among hospitalized children under 5 years, presents a substantial public health threat. This calls for continuous surveillance including molecular
characterization of isolates, to inform infection prevention and antimicrobial stewardship adherence in line with
local and global plans on AMR.
Description
Article
Keywords
Carbapenem-resistant Enterobacteriaceae, Carbapenem-producing Enterobacteriaceae, Gastrointestinal carriage, Multidrug-resistant