Faecal Carriage of Multidrug Resistant Enterobacterales and Associated Factors among Neonates Admitted at Tertiary Hospital in Dar es Salaam, Tanzania

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Published Jan 30, 2025
DOI https://doi.org/10.24248/eahrj.v8i3.804

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Doreen Kamori
Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania;
Hadija A. Salega
Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania;
Upendo O. Kibwana
Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania;
Joel Manyahi
Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania;
Agricola Joachim
Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania;
Salim Masoud
Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania;
Ambele M. Mwandigh
Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania;
Mtebe V. Majigo
Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania;
Mariam Mirambo
Department of Microbiology and Immunology, Catholic University of Health Allied Sciences, Mwanza, Tanzania.
Martha F. Mushi
Department of Microbiology and Immunology, Catholic University of Health Allied Sciences, Mwanza, Tanzania.
Stephen E. Mshana
Department of Microbiology and Immunology, Catholic University of Health Allied Sciences, Mwanza, Tanzania.

Abstract

Background: Hospitalised neonates are at increased risk of carrying extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) and carbapenemase-producing Enterobacterales (CPE), possibly leading to invasive infections. This study determined the faecal carriage of ESBL-PE, CPE, and associated factors among neonates at Muhimbili National Hospital (MNH).
Methods: A hospital-based cross-sectional study was conducted among neonates aged ≤ 28 days admitted at MNH. The participants’ data and rectal swab samples were collected. Samples were processed to detect ESBL-PE and CPE. Results were confirmed using the double-disc diffusion synergy test and modified carbapenem inactivation method, respectively. An antimicrobial susceptibility test was performed using the Kirby Bauer disk diffusion method.
Results: Three hundred forty neonates with a median age of 3 days (IQR: 2-9) were enrolled. The carriage rate of ESBL-E and CPE was 39.4%(134/340) and 1.8%(6/340), respectively. Klebsiella pneumoniae (66.9%) and Escherichia coli (66.7%) were the common isolates for ESBL-PE and CPE, respectively. The factors independently associated with ESBL-PE carriage were antibiotic use (aOR 2.73, 95% CI: 1.38-5.39, p=.04), age increase (aOR 1.09, 95% CI: 1.02-1.15, p=.006), prolonged hospitalisation (aOR 2.92, 95% CI: 1.17-7.29, p=.02), and neonate-sucking their fingers (aOR 2.98, 95% CI: 1.04-8.58, p=.04). The study observed a trend of CPE carriage toward neonates with prolonged hospitalisation (p=.05). ESBL-PE low resistance was observed to meropenem (0.9%), amikacin (2.7%-6.7%), and gentamicin (19.4% to 100 %).
Conclusions: The study revealed a relatively high carriage rate of multidrug resistant Enterobacterales among neonates admitted to a tertiary hospital. These findings underscore the importance of continuous surveillance of ESBL-PE and CPE to prevent infections and limit their potential transmission within hospital settings and the community.

Article Details

Issue
Vol 8 No 3 (2024): East African Health Research Journal
Section
Original Articles