Multicountry Distribution and Characterization of Extended-spectrum β-Lactamase-associated Gram-negative Bacteria From Bloodstream Infections in Sub-Saharan Africa.

Autor:	Toy T; International Vaccine Institute, Seoul, South Korea., Pak GD; International Vaccine Institute, Seoul, South Korea., Duc TP; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam., Campbell JI; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam., El Tayeb MA; Faculty of Medicine, University of Gezira, Wad Medani, Sudan., Von Kalckreuth V; International Vaccine Institute, Seoul, South Korea., Im J; International Vaccine Institute, Seoul, South Korea., Panzner U; International Vaccine Institute, Seoul, South Korea., Cruz Espinoza LM; International Vaccine Institute, Seoul, South Korea., Eibach D; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany., Dekker DM; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.; German Center for Infection Research, Hamburg-Borstel-Lübeck, Germany., Park SE; International Vaccine Institute, Seoul, South Korea., Jeon HJ; International Vaccine Institute, Seoul, South Korea.; Department of Medicine, Cambridge University, United Kingdom., Konings F; International Vaccine Institute, Seoul, South Korea., Mogeni OD; International Vaccine Institute, Seoul, South Korea.; Kenya Medical Research Institute-Centre for Global Health Research (KEMRI-CGHR), Nairobi., Cosmas L; Centers for Disease Control and Prevention, KEMRI Complex, Nairobi, Kenya., Bjerregaard-Andersen M; Bandim Health Project, Bissau, Guinea-Bissau.; Research Center for Vitamins and Vaccines, Copenhagen, Denmark., Gasmelseed N; Faculty of Medicine, University of Gezira, Wad Medani, Sudan.; Faculty of Science, University of Hafr Al Batin, Saudi Arabia., Hertz JT; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina., Jaeger A; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany., Krumkamp R; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany., Ley B; International Vaccine Institute, Seoul, South Korea.; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Australia., Thriemer K; International Vaccine Institute, Seoul, South Korea.; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Australia., Kabore LP; Schiphra Hospital, Ouagadougou, Burkina Faso., Niang A; Institute Pasteur de Dakar, Senegal., Raminosoa TM; University of Antananarivo, Antananarivo, Madagascar., Sampo E; Institut Supérieur des Sciences de la Population, University of Ouagadougou, Burkina Faso., Sarpong N; Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Ghana., Soura A; Institut Supérieur des Sciences de la Population, University of Ouagadougou, Burkina Faso., Owusu-Dabo E; Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Ghana.; Department of Global and International Health, School of Public Health, KNUST, Kumasi, Ghana., Teferi M; Armauer Hansen Research Institute, Addis Ababa, Ethiopia., Yeshitela B; Armauer Hansen Research Institute, Addis Ababa, Ethiopia., Poppert S; Infectious Diseases Department, University Hospital Eppendorf, Hamburg, Germany., May J; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.; German Center for Infection Research, Hamburg-Borstel-Lübeck, Germany., Kim JH; International Vaccine Institute, Seoul, South Korea., Chon Y; International Vaccine Institute, Seoul, South Korea., Park JK; International Vaccine Institute, Seoul, South Korea., Aseffa A; Armauer Hansen Research Institute, Addis Ababa, Ethiopia., Breiman RF; Kenya Medical Research Institute-Centre for Global Health Research (KEMRI-CGHR), Nairobi.; Global Health Institute, Emory University, Atlanta, Georgia., Schütt-Gerowitt H; International Vaccine Institute, Seoul, South Korea.; Institute of Medical Microbiology, University of Cologne, Germany., Aaby P; Bandim Health Project, Bissau, Guinea-Bissau.; Research Center for Vitamins and Vaccines, Copenhagen, Denmark., Adu-Sarkodie Y; Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Ghana.; Kwame Nkrumah University of Science and Technology, Kumasi, Ghana., Crump JA; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina.; Duke Global Health Institute, Duke University, Durham, North Carolina.; Centre for International Health, University of Otago, Dunedin, New Zealand., Rakotozandrindrainy R; University of Antananarivo, Antananarivo, Madagascar., Meyer CG; Institute of Tropical Medicine, Eberhard-Karls University Tübingen, Germany.; Duy Tan University, Da Nang, Vietnam., Sow AG; Institute Pasteur de Dakar, Senegal.; Université Cheikh Anta Diop de Dakar, Senegal., Clemens JD; International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.; University of California, Fielding School of Public Health, Los Angeles.; School of Medicine, Korea University, Seoul, South Korea., Wierzba TF; International Vaccine Institute, Seoul, South Korea., Baker S; Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.; Department of Medicine, Cambridge University, United Kingdom., Marks F; International Vaccine Institute, Seoul, South Korea.; Department of Medicine, Cambridge University, United Kingdom.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2019 Oct 30; Vol. 69 (Suppl 6), pp. S449-S458.
DOI:	10.1093/cid/ciz450
Abstrakt:	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. (© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.)
Databáze:	MEDLINE
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