Antimicrobial susceptibility profiles of Escherichia coli and Klebsiella pneumoniae isolated from outpatients in urban and rural districts of Uganda
Identifieur interne : 003750 ( Ncbi/Merge ); précédent : 003749; suivant : 003751Antimicrobial susceptibility profiles of Escherichia coli and Klebsiella pneumoniae isolated from outpatients in urban and rural districts of Uganda
Auteurs : Christine F. Najjuka [Ouganda] ; David P. Kateete [Ouganda] ; Henry M. Kajumbula [Ouganda] ; Moses L. Joloba [Ouganda] ; Sabiha Y. Essack [Afrique du Sud]Source :
- BMC Research Notes [ 1756-0500 ] ; 2016.
Abstract
Antimicrobial resistance is a global public health concern contributing to increased morbidity and mortality particularly in low-income countries. Studies on commensal bacteria are important as they reflect the state of antimicrobial susceptibility patterns in populations. However, susceptibility data on potentially pathogenic commensal bacteria from individuals in communities are still limited. The aim of this cross-sectional study was to determine the susceptibility profiles of
A total of 1448 participants were recruited into the study with 985 yielding organisms of interest from stool or urine samples (one per client). Most growth occurred from stool samples (636/985, 87 %), of which 620/636 (97 %) grew
Antimicrobial resistance is prevalent among
The online version of this article (doi:10.1186/s13104-016-2049-8) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s13104-016-2049-8
PubMed: 27113038
PubMed Central: 4843195
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Antimicrobial susceptibility profiles of <italic>Escherichia coli</italic> and <italic>Klebsiella pneumoniae</italic> isolated from outpatients in urban and rural districts of Uganda</title><author><name sortKey="Najjuka, Christine F" sort="Najjuka, Christine F" uniqKey="Najjuka C" first="Christine F." last="Najjuka">Christine F. Najjuka</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Kateete, David P" sort="Kateete, David P" uniqKey="Kateete D" first="David P." last="Kateete">David P. Kateete</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Kajumbula, Henry M" sort="Kajumbula, Henry M" uniqKey="Kajumbula H" first="Henry M." last="Kajumbula">Henry M. Kajumbula</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Joloba, Moses L" sort="Joloba, Moses L" uniqKey="Joloba M" first="Moses L." last="Joloba">Moses L. Joloba</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Essack, Sabiha Y" sort="Essack, Sabiha Y" uniqKey="Essack S" first="Sabiha Y." last="Essack">Sabiha Y. Essack</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Antimicrobial Research Unit, School of Health Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Antimicrobial Research Unit, School of Health Sciences, University of KwaZulu-Natal, Westville, Durban</wicri:regionArea><wicri:noRegion>Durban</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27113038</idno><idno type="pmc">4843195</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843195</idno><idno type="RBID">PMC:4843195</idno><idno type="doi">10.1186/s13104-016-2049-8</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000818</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000818</idno><idno type="wicri:Area/Pmc/Curation">000817</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000817</idno><idno type="wicri:Area/Pmc/Checkpoint">000852</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000852</idno><idno type="wicri:Area/Ncbi/Merge">003750</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Antimicrobial susceptibility profiles of <italic>Escherichia coli</italic> and <italic>Klebsiella pneumoniae</italic> isolated from outpatients in urban and rural districts of Uganda</title><author><name sortKey="Najjuka, Christine F" sort="Najjuka, Christine F" uniqKey="Najjuka C" first="Christine F." last="Najjuka">Christine F. Najjuka</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Kateete, David P" sort="Kateete, David P" uniqKey="Kateete D" first="David P." last="Kateete">David P. Kateete</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Kajumbula, Henry M" sort="Kajumbula, Henry M" uniqKey="Kajumbula H" first="Henry M." last="Kajumbula">Henry M. Kajumbula</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Joloba, Moses L" sort="Joloba, Moses L" uniqKey="Joloba M" first="Moses L." last="Joloba">Moses L. Joloba</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Essack, Sabiha Y" sort="Essack, Sabiha Y" uniqKey="Essack S" first="Sabiha Y." last="Essack">Sabiha Y. Essack</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Antimicrobial Research Unit, School of Health Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Antimicrobial Research Unit, School of Health Sciences, University of KwaZulu-Natal, Westville, Durban</wicri:regionArea><wicri:noRegion>Durban</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Research Notes</title><idno type="eISSN">1756-0500</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Antimicrobial resistance is a global public health concern contributing to increased morbidity and mortality particularly in low-income countries. Studies on commensal bacteria are important as they reflect the state of antimicrobial susceptibility patterns in populations. However, susceptibility data on potentially pathogenic commensal bacteria from individuals in communities are still limited. The aim of this cross-sectional study was to determine the susceptibility profiles of <italic>Escherichia coli</italic> and Klebsiella species isolated from clients attending outpatient clinics in Kampala (urban district) and two rural districts of Uganda, Kayunga and Mpigi. Factors associated with such carriage are also reported.</p></sec><sec><title>Results</title><p>A total of 1448 participants were recruited into the study with 985 yielding organisms of interest from stool or urine samples (one per client). Most growth occurred from stool samples (636/985, 87 %), of which 620/636 (97 %) grew <italic>E. coli</italic> while 16 (3 %) were <italic>Klebsiella pneumonia</italic>e. Growth from urine was 349/985 (35 %) of which 310/349 (89 %) were <italic>E. coli</italic> while 39 (11 %) <italic>K. pneumoniae.</italic> High rates of antimicrobial resistance were detected among <italic>E. coli</italic> and Klebsiella isolates combined: sulphamethoxazole/trimethoprim 70 %, amoxicillin/clavulanate 36 %, chloramphenicol 20 %, ciprofloxacin 11 %, gentamicin 11 %, nitrofurantoin 4 %, ceftriaxone 3 %, piperacillin/tazobactam 27 %, cefoxitin 22 %, and cefepime 15 %. Multidrug resistance was noted in 33 % of the isolates. None of the isolates were resistant to imipenem. Overall, isolates from Kampala were more resistant to antimicrobials. Across the three districts combined, isolates producing beta-lactamase enzymes extended spectrum β-lactamase-(ESBL) and AmpC comprised 5.3 and 13.2 %, respectively. Further, medical procedures involving inoculation were independent risk factors [aOR 50.76 (1.80, 1432.90)] while residing in a rural district and use of sulphamethoxazole/trimethoprim 3 months prior to visiting the outpatient clinics were protective against carriage of multidrug resistant isolates. Furthermore, use of gentamicin was protective against AmpC producing isolates while clients attending HIV/AIDs clinics were less likely to carry such isolates. No factor was independently associated with carriage of ESBL-producing isolates.</p></sec><sec><title>Conclusion</title><p>Antimicrobial resistance is prevalent among <italic>E. coli</italic> and <italic>K.</italic><italic>pneumoniae</italic> carried in the gut of clients attending outpatient clinics in Kampala and two rural districts in Uganda. This could complicate treatment options for community-acquired infections caused by the <italic>Enterobacteriaceae</italic>.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s13104-016-2049-8) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Gootz, Td" uniqKey="Gootz T">TD Gootz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lester, Sc" uniqKey="Lester S">SC Lester</name></author><author><name sortKey="Del Pilar Pl, M" uniqKey="Del Pilar Pl M">M del Pilar Pl</name></author><author><name sortKey="Wang, F" uniqKey="Wang F">F Wang</name></author><author><name sortKey="Perez Schael, I" uniqKey="Perez Schael I">I Perez Schael</name></author><author><name sortKey="Jiang, H" uniqKey="Jiang H">H Jiang</name></author><author><name sortKey="O Rien, Tf" uniqKey="O 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sortKey="Bhutta, Za" uniqKey="Bhutta Z">ZA Bhutta</name></author><author><name sortKey="Abbas, Z" uniqKey="Abbas Z">Z Abbas</name></author><author><name sortKey="Goldmann, Da" uniqKey="Goldmann D">DA Goldmann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kariuki, S" uniqKey="Kariuki S">S Kariuki</name></author><author><name sortKey="Dougan, G" uniqKey="Dougan G">G Dougan</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Res Notes</journal-id><journal-id journal-id-type="iso-abbrev">BMC Res Notes</journal-id><journal-title-group><journal-title>BMC Research Notes</journal-title></journal-title-group><issn pub-type="epub">1756-0500</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27113038</article-id><article-id pub-id-type="pmc">4843195</article-id><article-id pub-id-type="publisher-id">2049</article-id><article-id pub-id-type="doi">10.1186/s13104-016-2049-8</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Antimicrobial susceptibility profiles of <italic>Escherichia coli</italic> and <italic>Klebsiella pneumoniae</italic> isolated from outpatients in urban and rural districts of Uganda</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Najjuka</surname><given-names>Christine F.</given-names></name><address><phone>256-414-541830</phone><email>najjukafc@gmail.com</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Kateete</surname><given-names>David P.</given-names></name><address><email>davidkateete@gmail.com</email></address><xref ref-type="aff" rid="Aff1"></xref><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Kajumbula</surname><given-names>Henry M.</given-names></name><address><email>henrykajumbula427@gmail.com</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Joloba</surname><given-names>Moses L.</given-names></name><address><email>mlj10@case.edu</email></address><xref ref-type="aff" rid="Aff1"></xref><xref ref-type="aff" rid="Aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Essack</surname><given-names>Sabiha Y.</given-names></name><address><email>essacks@ukzn.ac.za</email></address><xref ref-type="aff" rid="Aff3"></xref></contrib><aff id="Aff1"><label></label>Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda</aff><aff id="Aff2"><label></label>Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala, Uganda</aff><aff id="Aff3"><label></label>Antimicrobial Research Unit, School of Health Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa</aff></contrib-group><pub-date pub-type="epub"><day>25</day><month>4</month><year>2016</year></pub-date><pub-date pub-type="pmc-release"><day>25</day><month>4</month><year>2016</year></pub-date><pub-date pub-type="collection"><year>2016</year></pub-date><volume>9</volume><elocation-id>235</elocation-id><history><date date-type="received"><day>10</day><month>7</month><year>2015</year></date><date date-type="accepted"><day>18</day><month>4</month><year>2016</year></date></history><permissions><copyright-statement>© Najjuka et al. 2016</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>Antimicrobial resistance is a global public health concern contributing to increased morbidity and mortality particularly in low-income countries. Studies on commensal bacteria are important as they reflect the state of antimicrobial susceptibility patterns in populations. However, susceptibility data on potentially pathogenic commensal bacteria from individuals in communities are still limited. The aim of this cross-sectional study was to determine the susceptibility profiles of <italic>Escherichia coli</italic> and Klebsiella species isolated from clients attending outpatient clinics in Kampala (urban district) and two rural districts of Uganda, Kayunga and Mpigi. Factors associated with such carriage are also reported.</p></sec><sec><title>Results</title><p>A total of 1448 participants were recruited into the study with 985 yielding organisms of interest from stool or urine samples (one per client). Most growth occurred from stool samples (636/985, 87 %), of which 620/636 (97 %) grew <italic>E. coli</italic> while 16 (3 %) were <italic>Klebsiella pneumonia</italic>e. Growth from urine was 349/985 (35 %) of which 310/349 (89 %) were <italic>E. coli</italic> while 39 (11 %) <italic>K. pneumoniae.</italic> High rates of antimicrobial resistance were detected among <italic>E. coli</italic> and Klebsiella isolates combined: sulphamethoxazole/trimethoprim 70 %, amoxicillin/clavulanate 36 %, chloramphenicol 20 %, ciprofloxacin 11 %, gentamicin 11 %, nitrofurantoin 4 %, ceftriaxone 3 %, piperacillin/tazobactam 27 %, cefoxitin 22 %, and cefepime 15 %. Multidrug resistance was noted in 33 % of the isolates. None of the isolates were resistant to imipenem. Overall, isolates from Kampala were more resistant to antimicrobials. Across the three districts combined, isolates producing beta-lactamase enzymes extended spectrum β-lactamase-(ESBL) and AmpC comprised 5.3 and 13.2 %, respectively. Further, medical procedures involving inoculation were independent risk factors [aOR 50.76 (1.80, 1432.90)] while residing in a rural district and use of sulphamethoxazole/trimethoprim 3 months prior to visiting the outpatient clinics were protective against carriage of multidrug resistant isolates. Furthermore, use of gentamicin was protective against AmpC producing isolates while clients attending HIV/AIDs clinics were less likely to carry such isolates. No factor was independently associated with carriage of ESBL-producing isolates.</p></sec><sec><title>Conclusion</title><p>Antimicrobial resistance is prevalent among <italic>E. coli</italic> and <italic>K.</italic><italic>pneumoniae</italic> carried in the gut of clients attending outpatient clinics in Kampala and two rural districts in Uganda. This could complicate treatment options for community-acquired infections caused by the <italic>Enterobacteriaceae</italic>.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/s13104-016-2049-8) contains supplementary material, which is available to authorized users.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Antimicrobial resistance</kwd><kwd><italic>Escherichia coli</italic></kwd><kwd><italic>Klebsiella pneumoniae</italic></kwd><kwd>Outpatient clinic</kwd><kwd>Commensal bacteria</kwd><kwd>Urban</kwd><kwd>Rural</kwd><kwd>Kampala</kwd><kwd>Uganda</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2016</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Afrique du Sud</li><li>Ouganda</li></country></list><tree><country name="Ouganda"><noRegion><name sortKey="Najjuka, Christine F" sort="Najjuka, Christine F" uniqKey="Najjuka C" first="Christine F." last="Najjuka">Christine F. Najjuka</name></noRegion><name sortKey="Joloba, Moses L" sort="Joloba, Moses L" uniqKey="Joloba M" first="Moses L." last="Joloba">Moses L. Joloba</name><name sortKey="Joloba, Moses L" sort="Joloba, Moses L" uniqKey="Joloba M" first="Moses L." last="Joloba">Moses L. Joloba</name><name sortKey="Kajumbula, Henry M" sort="Kajumbula, Henry M" uniqKey="Kajumbula H" first="Henry M." last="Kajumbula">Henry M. Kajumbula</name><name sortKey="Kateete, David P" sort="Kateete, David P" uniqKey="Kateete D" first="David P." last="Kateete">David P. Kateete</name><name sortKey="Kateete, David P" sort="Kateete, David P" uniqKey="Kateete D" first="David P." last="Kateete">David P. Kateete</name></country><country name="Afrique du Sud"><noRegion><name sortKey="Essack, Sabiha Y" sort="Essack, Sabiha Y" uniqKey="Essack S" first="Sabiha Y." last="Essack">Sabiha Y. Essack</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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