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Cited by 55Antibiotic Resistance in BacteriaAntibiotic Use and ResistanceInfections and bacterial resistance

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 access
Musila, Lillian, Kyany’a, Cecilia, Maybank, Rosslyn, Stam, Jason, Oundo, Valerie, Sang, Willie·2021·PLOS ONE
DOI 10.1371/journal.pone.0246937PMC PMC7899328
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Abstract

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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Fig 1 The geographical distribution of the carbapenem non-susceptible gram-negative bacteria and carbapenemase genes in five Kenyan counties. The map of Kenya with the study counties highlighted. The pie charts indicate the distribution of bacterial species, carbapenemase genes identified and the number of each isolate type detected. This custom map was generated in-house using the ArcGIS software Version 10.3.1 (Environmental Systems Research Institute, Red-lands, CA, USA).
Fig 1 The geographical distribution of the carbapenem non-susceptible gram-negative bacteria and carbapenemase genes in five Kenyan counties. The map of Kenya with the study counties highlighted. The pie charts indicate the distribution of bacterial species, carbapenemase genes identified and the number of each isolate type detected. This custom map was generated in-house using the ArcGIS software Version 10.3.1 (Environmental Systems Research Institute, Red-lands, CA, USA).CC BY · PubMed Central

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Research works printed but not linked: 2

  1. World Health Organization, 2014, Antimicrobial Resistance: Global Report on Surveillance
  2. KJS Mukaya, 2018, Antimicrobial Resistance Profile and Genetic Profiling of Pseudomonas aeruginosa Strains Obtained from Different Inpatient Wards at Kenyatta National Hospital, IOSR Journal of Pharmacy and Biological Sciences (IOSR-JPBS), 13

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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
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2021-02-22
Volume
16
Issue
2
Pages
e0246937
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0246937
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
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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