Carbapenemase-producing Enterobacteriaceae detected in nearly one-fifth of clinical isolates in Addis Ababa
Investigators evaluated 1105 clinical specimens from a private diagnostic laboratory in Addis Ababa, Ethiopia, isolating 156 Enterobacteriaceae. Employing MALDI-TOF mass spectrometry, Kirby-Bauer disk diffusion, and the modified carbapenem inactivation method, they reported that 78.8 percent of isolates were multidrug resistant and 19.5 percent were carbapenemase producers, with Klebsiella pneumoniae accounting for 80 percent of resistant cases. The results demonstrate the practical value of routine phenotypic susceptibility testing and mCIM assays in resource-constrained settings for monitoring antimicrobial resistance. These data provide a baseline for laboratory directors to optimize infection control and antimicrobial stewardship protocols in Ethiopian healthcare facilities.
The original study
Multidrug resistance and carbapenemase producing Enterobacteriaceae isolated from clinical samples, Addis Ababa, Ethiopia: A cross-sectional study.
- Authors
- Getachew Y, Tamiru T, Fisseha M, Sebri S, Shume T, Diriba R, et al.
- Journal
- PloS one
- Type
- Journal Article
- PMID
- 42594141
Original abstract
BACKGROUND: Multidrug-resistant Enterobacteriaceae (MDRE) is among the leading causes of hospital-acquired infections, resulting in prolonged hospitalization, increased healthcare costs, and mortality. Carbapenem are often used as last-resort antibiotics; however, the emergence of carbapenemase-producing Enterobacteriaceae (CPE) has severely limited treatment options. In Ethiopia, data on their burden from routine diagnostic laboratory settings remain limited. This study assessed the prevalence of multidrug-resistant and carbapenemase-producing Enterobacteriaceae among clinical isolates in Addis Ababa. METHODS: A laboratory-based cross-sectional study was conducted from January 2, 2025, to April 2, 2025 on clinical specimens referred to Wudassie Advanced Medical Laboratory in Addis Ababa, Ethiopia. A total of 1105 clinical specimens collected through convenience sampling method were processed. Bacterial identification was performed using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) (EXS 3000, Zybio Inc., China). Antimicrobial susceptibility testing was conducted using the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI 2024) guidelines. Carbapenemase production was confirmed using the modified Carbapenem Inactivation Method (mCIM). Data were analyzed using SPSS version 26. RESULTS: Of the 1105 clinical specimens, 288/1105 (26.1%) showed bacterial growth. Enterobacteriaceae accounted for 156/288 (54.2%) of the isolates. The most common isolates were Escherichia coli 89/156 (57.1%) and Klebsiella pneumoniae 47/156 (30.1%). Overall, 123/156 (78.8%) of Enterobacteriaceae were multidrug resistant. Carbapenem resistance was detected in 35/154 (22.7%) of isolates, and 30/154 (19.5%) were confirmed as carbapenemase producers. Klebsiella pneumoniae 24/30 (80%) was the predominant carbapenemase-producing organism. Most CPE isolates were recovered from urine specimens, followed by wound and sputum samples. CONCLUSION: This study demonstrates a high prevalence of multidrug-resistant and carbapenemase-producing Enterobacteriaceae in Addis Ababa. The findings highlight the urgent need for strengthened antimicrobial stewardship programs, early detection strategies, and enhanced infection prevention and control measures in the private health facilities.