The DOI matches its Crossref record; 71 of the 71 references it cites were found in a registry or an index.
Detection of diverse carbapenem and multidrug resistance genes and high-risk strain types among carbapenem non-susceptible clinical isolates of target gram-negative bacteria in Kenya
Open accessAbstract
Carbapenem-resistant gram-negative bacteria are an increasingly significant clinical threat globally. This risk may be underestimated in Kenya as only four carbapenemase genes in three bacterial species have been described. The study aimed to understand the antibiotic resistance profiles, genes, sequence types, and distribution of carbapenem-resistant gram-negative bacteria from patients in six hospitals across five Kenyan counties by bacterial culture, antibiotic susceptibility testing, and whole-genome sequence analysis. Forty-eight, non-duplicate, carbapenem non-susceptible, clinical isolates were identified across the five counties (predominantly in Nairobi and Kisii): twenty-seven Acinetobacter baumannii, fourteen Pseudomonas aeruginosa, three Escherichia coli, two Enterobacter cloacae, and two Klebsiella pneumoniae. All isolates were non-susceptible to β-lactam drugs with variable susceptibility to tigecycline (66%), minocycline (52.9%), tetracycline (29.4%), and levofloxacin (22.9%). Thirteen P. aeruginosa isolates were resistant to all antibiotics tested. Eleven carbapenemase genes were identified: blaNDM-1, blaOXA-23, -58, -66, -69, and -91 in A. baumannii (STs 1, 2, 164 and a novel ST1475), blaNDM-1 in E. cloacae (STs 25,182), blaNDM-1, blaVIM-1and -6, blaOXA-50 in P. aeruginosa (STs 316, 357, 654, and1203), blaOXA-181, blaNDM-1 in K. pneumoniae (STs 147 and 219), and blaNDM-5 in E. coli (ST164). Five A. baumannii isolates had two carbapenemases, blaNDM-1, and either blaOXA-23 (4) or blaOXA-58 (1). AmpC genes were detected in A. baumannii (blaADC-25), E. cloacae (blaDHA-1 and blaACT-6, 16), and K. pneumoniae (bla CMY). Significant multiple-drug resistant genes were the pan-aminoglycoside resistance16srRNA methyltransferase arm A, rmt B, rmt C, and rmt F genes. This study is the first to report blaOXA-420, -58, -181, VIM-6, and blaNDM-5 in Kenyan isolates. High-risk STs of A. baumannii (ST1475, ST2), E. cloacae ST182, K. pneumoniae ST147, P. aeruginosa (ST357, 654), and E. coli ST167, ST648 were identified which present considerable therapeutic danger. The study recommends urgent carbapenem use regulation and containment of high-risk carbapenem-resistant bacteria.
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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 [147]
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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
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Metadata
- Authors
- Musila, L., Kyany’a, C., Maybank, R., Stam, J., Oundo, V., & Sang, W.
- Affiliations
- United States Army Medical Research Directorate - Africa (KE)
- Walter Reed Army Institute of Research (US)
- Corresponding author
- Musila, Lillian
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2021-02-22
- Volume
- 16
- Issue
- 2
- Pages
- e0246937
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC7899328
- OpenAlex
- W3132704259
- Cited by
- 55
- References
- 71
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 9 · 2023: 11 · 2022: 18 · 2021: 5
- FWCI
- 3.41
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Armed Forces Health Surveillance Branch (PROMIS ID 20160270153 FY17)
- 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, carbapenemase genes, multidrug resistance, Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae, NDM-1, OXA-23, OXA-58, VIM-1, AmpC beta-lactamase, sequence types, antimicrobial resistance surveillance, Kenya, clinical isolates, whole genome sequencing, tigecycline
- MeSH terms
- Anti-Bacterial Agents, Genes, Bacterial, Gram-Negative Bacteria, Humans, Kenya, Carbapenems, Gram-Negative Bacterial Infections, Genes, MDR, Drug Resistance, Bacterial
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- Musila, L., Kyany’a, C., Maybank, R., Stam, J., Oundo, V., & Sang, W. (2021). Detection of diverse carbapenem and multidrug resistance genes and high-risk strain types among carbapenem non-susceptible clinical isolates of target gram-negative bacteria in Kenya. PLOS ONE. https://doi.org/10.1371/journal.pone.0246937
