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Carbapenem resistant Pseudomonas aeruginosa and Acinetobacter baumannii at Mulago Hospital in Kampala, Uganda (2007–2009)
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BACKGROUND: Multidrug resistant Pseudomonas aeruginosa and Acinetobacter baumannii are common causes of health care associated infections worldwide. Carbapenems are effective against infections caused by multidrug resistant Gram-negative bacteria including Pseudomonas and Acinetobacter species. However, their use is threatened by the emergence of carbapenemase-producing strains. The aim of this study was to determine the prevalence of carbapenem-resistant P. aeruginosa and A. baumannii at Mulago Hospital in Kampala Uganda, and to establish whether the hospital environment harbors carbapenem-resistant Gram-negative rods. RESULTS: Between February 2007 and September 2009, a total of 869 clinical specimens were processed for culture and sensitivity testing yielding 42 (5 %) P. aeruginosa and 29 (3 %) A. baumannii isolates, of which 24 % (10/42) P. aeruginosa and 31 % (9/29) A. baumannii were carbapenem-resistant. Additionally, 80 samples from the hospital environment were randomly collected and similarly processed yielding 58 % (46/80) P. aeruginosa and 14 % (11/80) A. baumannii, of which 33 % (15/46) P. aeruginosa and 55 % (6/11) A. baumannii were carbapenem-resistant. The total number of isolates studied was 128. Carbapenemase genes detected were bla IMP-like (36 %, 9/25), bla VIM-like (32 %, 8/25), bla SPM-like (16 %, 4/25); bla NDM-1-like (4 %, 1/25) in carbapenem-resistant P. aeruginosa, and bla OXA-23-like (60 %, 9/15), bla OXA-24-like (7 %, 1/15), bla OXA-58-like (13 %, 2/15), and bla VIM-like (13 %, 2/15) in carbapenem-resistant A. baumannii. Furthermore, class 1 integrons were detected in 38 % (48/128) of P. aeruginosa and Acinetobacter, 37 % (26/71) of which were in clinical isolates and 39 % (22/57) in environment isolates. Gene cassettes were found in 25 % (12/48) of integron-positive isolates. These were aminoglycoside adenylyltransferase ant(4')-IIb (3 isolates); trimethoprim-resistant dihydrofolate reductase dfrA (2 isolates); adenyltransferase aadAB (3 isolates); QacE delta1 multidrug exporter (2 isolates); quinolone resistance pentapeptide repeat protein qnr (1 isolate); and metallo-β-lactamase genes bla VIM-4-like, bla IMP-19-like, and bla IMP-26-like (1 isolate each). Gene cassettes were missing in 75 % (36/48) of the integron-positive isolates. CONCLUSIONS: The prevalence of carbapenem-resistant P. aeruginosa and Acinetobacter among hospitalized patients at Mulago Hospital is low compared to rates from South-East Asia. However, it is high among isolates and in the environment, which is of concern given that the hospital environment is a potential source of infection for hospitalized patients and health care workers.
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“The cooccurrence of class I and class II integrons has also been reported, which possess a variety of resistance genes, such as ant(4′)-IIb, dfrA, aadAB, qnrVC1, gyrA, and parC.147,177,179,181,182,[184][185][186][187]”
From Antimicrobial Resistance Rates and Surveillance in Sub-Saharan Africa: Where Are We Now? (2022) · cites this paper as [177]
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“The prevalence of carbapenem-resistant P. aeruginosa ranges from 6% to 34.8%, as reported in various studies conducted in Uganda, Ghana, South Africa, Zambia, Nigeria, and Ethiopia.[176][177][178][179][180][181]”
From Antimicrobial Resistance Rates and Surveillance in Sub-Saharan Africa: Where Are We Now? (2022) · cites this paper as [177]
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Antimicrobial Resistance Rates and Surveillance in Sub-Saharan Africa: Where Are We Now?
Kariuki, S., Kering, K., Wairimu, C., Onsare, R., & Mbae, C. (2022) · Infection and Drug Resistance · doi:10.2147/idr.s342753 · Cited by 245
Metadata
- Authors
- Kateete, D. P., Nakanjako, R., Namugenyi, J., Erume, J., Joloba, M. L., & Najjuka, C. F.
- Affiliations
- Makerere University (UG)
- Johns Hopkins University (US)
- Corresponding author
- Najjuka, Christine F.
- ORCID
- Venue
- SpringerPlus
- Published
- 2016-08-09
- Volume
- 5
- Issue
- 1
- Pages
- 1308-1308
- ISSN
- 2193-1801 (ISSN-L)
- PMC
- PMC4978656
- OpenAlex
- W2517313720
- Cited by
- 84
- References
- 0
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 8 · 2023: 12 · 2022: 9 · 2021: 13 · 2020: 8 · 2019: 9 · 2018: 10 · 2017: 4
- FWCI
- 3.74
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- SpringerPlus (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Ministry of Health, Uganda
- University of Health and Allied Sciences
- National Institute of Allergy and Infectious Diseases (R01AI075637, R03AI062849)
- Topics
- Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
- Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
- Health Sciences › Medicine › Microbiology (medical) › Infections and bacterial resistance
- Keywords
- carbapenem resistance, Pseudomonas aeruginosa, Acinetobacter baumannii, carbapenemase genes, class 1 integron, hospital environmental contamination, nosocomial infections, multidrug resistance, Gram-negative bacteria, Mulago Hospital, Uganda, prevalence, antimicrobial susceptibility
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