TY - JOUR
T1 - Multicountry Distribution and Characterization of Extended-spectrum β-Lactamase-associated Gram-negative Bacteria from Bloodstream Infections in Sub-Saharan Africa
AU - Toy, Trevor
AU - Pak, Gi Deok
AU - Duc, Trung Pham
AU - Campbell, James I.
AU - El Tayeb, Muna Ahmed
AU - Von Kalckreuth, Vera
AU - Im, Justin
AU - Panzner, Ursula
AU - Cruz Espinoza, Ligia Maria
AU - Eibach, Daniel
AU - Dekker, Denise Myriam
AU - Park, Se Eun
AU - Jeon, Hyon Jin
AU - Konings, Frank
AU - Mogeni, Ondari D.
AU - Cosmas, Leonard
AU - Bjerregaard-Andersen, Morten
AU - Gasmelseed, Nagla
AU - Hertz, Julian T.
AU - Jaeger, Anna
AU - Krumkamp, Ralf
AU - Ley, Benedikt
AU - Thriemer, Kamala
AU - Kabore, Leon Parfait
AU - Niang, Aissatou
AU - Raminosoa, Tiana Mirana
AU - Sampo, Emmanuel
AU - Sarpong, Nimako
AU - Soura, Abdramane
AU - Owusu-Dabo, Ellis
AU - Teferi, Mekonnen
AU - Yeshitela, Biruk
AU - Poppert, Sven
AU - May, Jürgen
AU - Kim, Jerome H.
AU - Chon, Yun
AU - Park, Jin Kyung
AU - Aseffa, Abroaham
AU - Breiman, Robert F.
AU - Schütt-Gerowitt, Heidi
AU - Aaby, Peter
AU - Adu-Sarkodie, Yaw
AU - Crump, John A.
AU - Rakotozandrindrainy, Raphaël
AU - Meyer, Christian G.
AU - Sow, Amy Gassama
AU - Clemens, John D.
AU - Wierzba, Thomas F.
AU - Baker, Stephen
AU - Marks, Florian
PY - 2019/10/30
Y1 - 2019/10/30
N2 - Background: 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. Methods: 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. Results: 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. Conclusions: 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.
AB - Background: 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. Methods: 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. Results: 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. Conclusions: 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.
KW - Africa
KW - antibiotic resistance
KW - antimicrobial resistance
KW - ESBL
KW - extended-spectrum β-lactamase
KW - surveillance
UR - http://www.scopus.com/inward/record.url?scp=85074337131&partnerID=8YFLogxK
U2 - 10.1093/cid/ciz450
DO - 10.1093/cid/ciz450
M3 - Article
C2 - 31665776
AN - SCOPUS:85074337131
SN - 1058-4838
VL - 69
SP - S449-S458
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - Supplement_6
ER -