Bacterial profile and their antimicrobial susceptibility patterns in patients admitted at MaddaWalabu University Goba Referral Hospital, Ethiopia: a cross sectional study

A comparative study on nosocomial and community-acquired bacterial urinary tract infections: prevalence, antimicrobial susceptibility pattern, and associated risk factors among symptomatic patients attending Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia

Background

Urinary tract infections (UTIs) remain one of the most common diseases worldwide that occur both in the community and in healthcare settings. Thus, this study aimed to compare the burden of nosocomial and community-acquired bacterial UTIs among patients attending Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia.

Method

A hospital-based cross-sectional study was conducted using a convenient sampling technique from January 2024 to April 2024. Descriptive statistics were employed, and bivariate and multivariable logistic regression analyses were used to identify associated factors at p < 0.05 with a 95% confidence interval (CI) considered statistically significant.

Results

The rate of hospital-acquired UTIs was 42% (95% CI: 35-50), while the rate of community-acquired UTIs was 28% (95% CI: 22-36). The predominant bacterial isolates were Escherichia coli (37%), Staphylococcus aureus (7.8%), and Klebsiella pneumoniae (7.8%). The overall multidrug resistance rate was 91 (77.8%). Lack of formal education [adjusted odds ratio (AOR), 0.02; 95% CI: 0.001-0.6], surgery during admission (AOR, 0.02; 95% CI: 0.002-0.3), delay in voiding urine (AOR, 0.01; 95% CI: 0.005-0.1), previous UTIs (AOR, 0.04; 95% CI: 0.004-0.4), and previous admission (AOR, 0.07; 95% CI: 0.01-0.5) were the main factors significantly associated with bacterial UTIs.

Conclusions

A significantly higher prevalence of hospital-acquired bacterial UTIs was observed compared to community-acquired bacterial UTIs. The commonest isolates were E.coli, S. aureus, and K. pneumoniae. The drug resistance rate was very high. Modifiable individual-level factors were the major significant factors of UTIs. Thus, health workers and other stakeholders should tackle UTIs by increasing community awareness, promoting personal hygiene, and improving healthcare service quality.

Magnitude of Health Care Associated Infections and its Clinical Predictors in Ethiopia: A Systematic Review and Meta-Analysis

BACKGROUND

Health care-acquired infections (HCAIs) are the growing global public health problems facing today requiring an immediate collaborative action of stockholders to be prevented and controlled. Thus, this study was aimed to assess the magnitude and clinical related factors of HCAIs in Ethiopia.

METHODS

Articles were extensively searched in bibliographic databases and grey literatures using entry terms or phrases. Studies meeting eligibility criteria was extracted in Ms excel and exported in to STATA version 17 software for statistical analysis. A random-effect model was used to compute the pooled magnitude of HCAIs using meta-prop. The heterogeneity was quantified by using the I2 value. Publication bias was assessed using a funnel plot and Egger's test. Sensitivity analysis, meta-regression and subgroup analysis were computed.

RESULT

Of the 1707 studies identified, 33 studies were selected for meta-analysis of magnitude of HCAIs. The overall pooled prevalence of HCAIs in Ethiopia was 37% (95% CI: 27.0-47.0%). The predominant bacterial aetiologies were E. coli. There was no single study effect and publication bias. Diabetes mellitus, comorbidities, contaminated wound, history of UTI and history of admission in ICU were statistically significant clinical predictors of HCAIs.

CONCLUSION

the pooled prevalence of HCAIs have alarmingly increased which underscores the importance of implementation of personalized infection prevention and control approach which identifies patients at risk of HCAIs from the point of admission maximizes the potential for prevention of HCAIs.

Antimicrobial resistance in bacterial wound, skin, soft tissue and surgical site infections in Central, Eastern, Southern and Western Africa: A systematic review and meta-analysis

Antimicrobial resistance (AMR) is a major global threat and AMR-attributable mortality is particularly high in Central, Eastern, Southern and Western Africa. The burden of clinically infected wounds, skin and soft tissue infections (SSTI) and surgical site infections (SSI) in these regions is substantial. This systematic review reports the extent of AMR from sampling of these infections in Africa, to guide treatment. It also highlights gaps in microbiological diagnostic capacity. PubMed, MEDLINE and Embase were searched for studies reporting the prevalence of Staphylococcus aureus, Eschericheria coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii in clinically infected wounds, SSTI and SSI in Central, Eastern, Southern or Western Africa, and studies reporting AMR from such clinical isolates. Estimates for proportions were pooled in meta-analyses, to estimate the isolation prevalence of each bacterial species and the proportion of resistance observed to each antibiotic class. The search (15th August 2022) identified 601 articles: 59 studies met our inclusion criteria. S. aureus was isolated in 29% (95% confidence interval [CI] 25% to 34%) of samples, E. coli in 14% (CI 11% to 18%), K. pneumoniae in 11% (CI 8% to 13%), P. aeruginosa in 14% (CI 11% to 18%) and A. baumannii in 8% (CI 5% to 12%). AMR was high across all five species. S. aureus was resistant to methicillin (MRSA) in >40% of isolates. E. coli and K. pneumoniae were both resistant to amoxicillin-clavulanic acid in ≥80% of isolates and resistant to aminoglycosides in 51% and 38% of isolates respectively. P. aeruginosa and A. baumannii were both resistant to anti-pseudomonal carbapenems (imipenem or meropenem) in ≥20% of isolates. This systematic review found that a large proportion of the organisms isolated from infected wounds, SSTI and SSI in Africa displayed resistance patterns of World Health Organisation (WHO) priority pathogens for critical or urgent antimicrobial development.

Detection of multidrug-resistant organisms of concern including Stenotrophomonas maltophilia and Burkholderia cepacia at a referral hospital in Kenya

Regular monitoring of bacterial susceptibility to antibiotics in clinical settings is key for ascertaining the current trends as well as re-establish empirical therapy. This study aimed to determine bacterial contaminants and their antimicrobial susceptibility patterns from medical equipment, inanimate surfaces and clinical samples obtained from Thika Level V Hospital (TLVH), Thika, in Central Kenya. Three hundred and five samples were collected between the period of March 2021 to November 2021 and comprised urine, pus swabs, catheter swabs, stool, and environmental samples. Bacterial identification and antimicrobial susceptibility were performed using VITEK 2 and disc diffusion respectively. We observed that Coagulase-negative Staphylococci (28 /160, 17.5%) were the most commonly isolated species from clinical samples followed by E. coli (22 /160 13.8%) and S. aureus (22/160, 13.8%). The bed rails were the mostly contaminated surface with S. aureus accounting for 14.2% (6/42). Among the clinical samples, pus swabs yielded the highest number of pathogens was pus (92/160). Trauma patients had the highest proportion of isolates (67/160, 41.8%). High level of antimicrobial resistance to key antimicrobials, particularly among Enterobacterales was observed. Extended Spectrum Beta Lactamase (ESBL) phenotype was noted in 65.9% (29/44) of enteric isolates. While further ESBL genetic confirmatory studies are needed, this study highlights the urgent need for actions that mitigate the spread of antibiotic-resistant bacteria.

Bacterial Profile and Their Antimicrobial Susceptibility Pattern of Isolates Recovered from Intensive Care Unit Environments at Wachemo University Nigist Ellen Mohammed Memorial Comprehensive Specialized Hospital, Southern Ethiopia

Background

Bacterial contamination of indoor hospitals, especially in intensive care units is a serious health hazard in the world with a high morbidity and mortality rates. Particularly, multidrug-resistant bacteria can cross-contaminate medical devices, inanimate surfaces, health care providers, and patients in the intensive care unit. This study was aimed to assess the bacterial profile and their antimicrobial susceptibility patterns of bacterial isolates from intensive care unit at WUNEMMCSH (Wachemo University Nigest Ellen Mohammed Memorial Compressive Specialized Hospital), Southern Ethiopia.

Methods

A hospital-based cross sectional study was conducted on 180 intensive care unit environmental samples at WUNEMMCSH from August 1, 2022, to October 30, 2022. In this study, a total of 180 swab samples were collected from medical devices, inanimate surfaces, patients, and health care providers from the intensive care unit by using sterile cotton-tipped swabs moistened with normal saline. Then, bacterial isolates were identified using the standard culture method, Gram stain, and biochemical tests. Antimicrobial susceptibility tests for bacterial isolates were performed by using the Kirby Bauer disk diffusion method. Data were entered into EpiData Version 4.6 cleanup and exported to SPSS V25 for analysis.

Results

A total of 180 swab samples were processed from intensive care unit environments, and 143 (79.4%) were found to have been contaminated by at least one potential pathogenic bacterial isolate. A total of two hundred and thirty-eight bacteria were isolated. Of these, the predominant bacteria were coagulase-negative Staphylococci 72 (30.3%), S. aureus 61 (25.6%), E. coli 41 (17.2%), and K. pneumoniae 30 (12.6%). Seventy (49%) out of all swabbed samples were contaminated with mixed isolates. In the antimicrobial susceptibility tests, 19 (86%) Gram-positive bacteria and 25 (76%) Gram-negative bacterial isolates were susceptible to nitrofurantoin, respectively. Vancomycin was sensitive to 83% of Gram-positive isolates. Gram-positive and Gram-negative isolates from irrespective sources showed multidrug resistance in 56.4% and 76.2%, respectively.

Conclusion

The inanimate hospital environments, medical device, health care providers, and patients in ICU rooms of WUNEMMCSH (Wachemo University Nigest Ellen Mohammed Memorial Comprehensive Specialized Hospital) were colonized with 143 (79.4%) of potential pathogenic bacterial isolate, which can cause nosocomial infections with high rates of morbidity and mortality among patients. The frequencies of multidrug-resistant 159 (66.8%) bacterial pathogens were alarmingly high. Therefore, to reduce the risk of bacterial contamination and MDR, strict adherence to hospital infection prevention and control measures should be enforced. These measures include regularly performing hand hygiene, periodic disinfection, and sterilization of medical equipment.

Editorial: Infectious diseases and NCDs persist despite concerted effort

Nil.