Carbapenem-Resistant Gram-Negative Bacterial Infections and Risk Factors for Acquisition in a Kenyan Intensive Care Unit

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dc.contributor.authorMaina, Jane Wairimu
dc.contributor.authorMutua, Jeniffer Munyiva
dc.contributor.authorMusyoki, Abednego Moki
dc.date.accessioned2024-05-29T09:29:25Z
dc.date.available2024-05-29T09:29:25Z
dc.date.issued2024-05
dc.descriptionArticleen_US
dc.description.abstractBackground Carbapenem-resistant Gram-negative bacteria (CR-GNB) are a critical public health threat globally; however, there are inadequate surveillance data, especially in intensive care units (ICU), to inform infection prevention and control in many resource-constrained settings. Here, we assessed the prevalence of CR-GNB infections and risk factors for acquisition in a Kenyan ICU. Methods A hospital-based cross-sectional study design was adopted, recruiting 162 patients clinically presenting with bacterial infection after 48 h of ICU admission, from January to October 2022 at the Nairobi West Hospital, Kenya. Demographics and clinical data were collected by case report form. The type of sample collected, including blood, tracheal aspirate, ascitic tap, urine, stool, and sputum depended on the patient’s clinical presentation and were transported to the hospital Microbiology laboratory in a cool box for processing within 2 h. The samples were analyzed by cultured and BD Phoenix system used for isolates’ identity and antimicrobial susceptibility. Results CR-GNB infections prevalence was 25.9% (42/162), with Klebsiella pneumoniae (35.7%, 15/42) and Pseudomonas aeruginosa (26.2%, 11/42) predominating. All isolates were multidrug-resistant (MDR). P. aeruginosa and A. baumannii were 100% colistin-resistant, while K. pneumoniae (33.3%) was tigecycline-resistant. History of antibiotics (aOR=3.40, p=0.005) and nasogastric tube (NGT) use (aOR=5.84, p=<0.001) were the risk factors for infection. Conclusion Our study highlights high MDR- and CR-GNB infections in ICU, with prior antibiotic exposure and NGT use as risk factors, and diminishing clinical value of colistin and tigecycline. In this study setting and beyond, strict implementation of antimicrobial stewardship programs and adherence to infection prevention and control through monitoring, evaluation and feedback are warranted to curb CR-GNB infections, especially among the risk groups.en_US
dc.identifier.citationMaina, J. W., Mutua, J. M., & Musyoki, A. M. (2024). Carbapenem-resistant gram-negative bacterial infections and risk factors for acquisition in a Kenyan intensive care unit. BMC Infectious Diseases, 24(1), 1-9.en_US
dc.identifier.urihttps://doi.org/10.1186/s12879-024-09256-6
dc.identifier.urihttps://ir-library.ku.ac.ke/handle/123456789/27919
dc.language.isoenen_US
dc.publisherBMCen_US
dc.subjectCarbapenem-resistant Gram-negative bacteriaen_US
dc.subjectMultiple antibiotic resistance indexen_US
dc.subjectMultidrug resistanceen_US
dc.subjectRisk factorsen_US
dc.titleCarbapenem-Resistant Gram-Negative Bacterial Infections and Risk Factors for Acquisition in a Kenyan Intensive Care Uniten_US
dc.typeArticleen_US
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