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Tufa TB, Fuchs A, Wienemann T, Eggers Y, Abdissa S, Schneider M, Jensen BEO, Bode JG, Pfeffer K, Häussinger D, Mackenzie CR, Orth HM, Feldt T. Carriage of ESBL-producing Gram-negative bacteria by flies captured in a hospital and its suburban surroundings in Ethiopia. Antimicrob Resist Infect Control 2020; 9:175. [PMID: 33148323 PMCID: PMC7640391 DOI: 10.1186/s13756-020-00836-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/22/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Local data from the Asella Teaching and Referral Hospital in the town of Asella, Ethiopia reveal a high prevalence of extended-spectrum β-lactamase- (ESBL) producing Gram-negative bacteria (GNB) in clinical isolates. To investigate a possible route of transmission, we determined the proportions ESBL-producing GNB in isolates from flies caught in the hospital and in the town of Asella. METHODS Flies were collected in August 2019 from the neonatal intensive care unit (NICU), the orthopedic ward, the hospital's waste disposal area, and from a butchery situated 1.5 km from the hospital. After trapping, the flies were macerated and suspended in sterile normal saline. The suspensions were inoculated on MacConkey agar and incubated overnight. Species identification and antimicrobial susceptibility testing were performed using Vitek®-MS and VITEK® 2. RESULTS In total, 103 bacterial isolates were obtained from 85 flies (NICU: 11 isolates from 20 flies, orthopedic ward: 10 isolates from 12 flies, waste disposal area: 37 isolates from 26 flies, butchery: 45 isolates from 27 flies). The proportions of ESBL-producing bacteria among isolates obtained from flies collected in the hospital compound were significantly higher (82%, 90%, and 57% in NICU, orthopedic ward and waste disposal area, respectively) compared to flies collected outside of the hospital compound (2% (@1/45) in the butchery) (p ≤ 0.001). The proportion of ESBL was 67% (6/9) among Raoultella spp. 67% (4/6) among Kluyvera spp., 56% (5/9) among Enterobacter spp., 50% (5/10) among E. coli, and 44% (8/18) among Klebsiella spp.. Of the 40 ESBL-genes detected, 85% were CTX-M-like, 83% TEM-like, 23% SHV-like, and 2% CTX-M-2-like. ESBL-producing bacteria showed higher rates of resistance against ciprofloxacin (66% vs. 5%), gentamicin (68% vs. 3%), piperacillin-tazobactam (78% vs. 5%), and trimethoprim-sulfamethoxazole (88% vs. 16%), compared to non-ESBL-producing bacteria. CONCLUSION A high proportion of ESBL was identified in isolates from flies caught in the hospital compound compared with isolates of flies collected at a distance of 1.5 km from the hospital. Flies can be potential vectors for transmission of multidrug-resistant (MDR) bacteria within hospitals. Further studies are needed to determine the source of MDR colonization in flies and possible impact of MDR for nosocomial infections.
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Affiliation(s)
- Tafese Beyene Tufa
- College of Health Sciences, Arsi University, P.O. Box 04, Asella, Ethiopia
- Hirsch Institute of Tropical Medicine, P.O. Box 04, Asella, Ethiopia
- Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital Center, Moorenstr. 5, 40225 Düsseldorf, Germany
- Institute of Medical Microbiology and Hospital Hygiene, Düsseldorf University Hospital Centre, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Andre Fuchs
- Hirsch Institute of Tropical Medicine, P.O. Box 04, Asella, Ethiopia
- Department of Infectious Diseases, Tropical Medicine, Nephrology and Rheumatology, St. Georg Hospital, Delitzscher Str. 141, 04129 Leipzig, Germany
| | - Tobias Wienemann
- Institute of Medical Microbiology and Hospital Hygiene, Düsseldorf University Hospital Centre, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Yannik Eggers
- Hirsch Institute of Tropical Medicine, P.O. Box 04, Asella, Ethiopia
- Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital Center, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Sileshi Abdissa
- College of Health Sciences, Arsi University, P.O. Box 04, Asella, Ethiopia
- Hirsch Institute of Tropical Medicine, P.O. Box 04, Asella, Ethiopia
- Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital Center, Moorenstr. 5, 40225 Düsseldorf, Germany
- Institute of Medical Microbiology and Hospital Hygiene, Düsseldorf University Hospital Centre, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Marlen Schneider
- Hirsch Institute of Tropical Medicine, P.O. Box 04, Asella, Ethiopia
- Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital Center, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Björn-Erik Ole Jensen
- Hirsch Institute of Tropical Medicine, P.O. Box 04, Asella, Ethiopia
- Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital Center, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Johannes G. Bode
- Hirsch Institute of Tropical Medicine, P.O. Box 04, Asella, Ethiopia
- Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital Center, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Klaus Pfeffer
- Institute of Medical Microbiology and Hospital Hygiene, Düsseldorf University Hospital Centre, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Dieter Häussinger
- Hirsch Institute of Tropical Medicine, P.O. Box 04, Asella, Ethiopia
- Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital Center, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Colin R. Mackenzie
- Institute of Medical Microbiology and Hospital Hygiene, Düsseldorf University Hospital Centre, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Hans Martin Orth
- Hirsch Institute of Tropical Medicine, P.O. Box 04, Asella, Ethiopia
- Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital Center, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Torsten Feldt
- Hirsch Institute of Tropical Medicine, P.O. Box 04, Asella, Ethiopia
- Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital Center, Moorenstr. 5, 40225 Düsseldorf, Germany
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