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Sepsis :
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Legese, Melese HailuUppsala universitet,Institutionen för medicinsk biokemi och mikrobiologi,Addis Ababa Univ, Coll Hlth Sci, Dept Med Lab Sci, Addis Ababa, Ethiopia; Armauer Hansen Res Inst, Addis Ababa, Ethiopia; Addis Ababa Univ, Coll Hlth Sci, Sch Med, Dept Microbiol Immunol & Parasitol, Addis Ababa, Ethiopia
(author)
Sepsis : emerging pathogens and antimicrobial resistance in Ethiopian referral hospitals
- Article/chapterEnglish2022
Publisher, publication year, extent ...
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2022-06-13
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BioMed Central (BMC),2022
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electronicrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-478643
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-478643URI
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https://doi.org/10.1186/s13756-022-01122-xDOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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BackgroundSepsis due to multidrug resistant (MDR) bacteria is a growing public health problem mainly in low-income countries.MethodsA multicenter study was conducted between October 2019 and September 2020 at four hospitals located in central (Tikur Anbessa and Yekatit 12), southern (Hawassa) and northern (Dessie) parts of Ethiopia. A total of 1416 patients clinically investigated for sepsis were enrolled. The number of patients from Tikur Anbessa, Yekatit 12, Dessie and Hawassa hospital was 501, 298, 301 and 316, respectively. At each study site, blood culture was performed from all patients and positive cultures were characterized by their colony characteristics, gram stain and conventional biochemical tests. Each bacterial species was confirmed using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI TOF). Antimicrobial resistance pattern of bacteria was determined by disc diffusion. Logistic regression analysis was used to assess associations of dependent and independent variables. A p-value < 0.05 was considered as statistically significant. The data was analyzed using SPSS version 25.ResultsAmong 1416 blood cultures performed, 40.6% yielded growth. Among these, 27.2%, 0.3% and 13.1%, were positive for pathogenic bacteria, yeast cells and possible contaminants respectively. Klebsiella pneumoniae (26.1%), Klebsiella variicola (18.1%) and E. coli (12.4%) were the most frequent. Most K. variicola were detected at Dessie (61%) and Hawassa (36.4%). Almost all Pantoea dispersa (95.2%) were isolated at Dessie. Rare isolates (0.5% or 0.2% each) included Leclercia adecarboxylata, Raoultella ornithinolytica, Stenotrophomonas maltophilia, Achromobacter xylosoxidans, Burkholderia cepacia, Kosakonia cowanii and Lelliottia amnigena. Enterobacteriaceae most often showed resistance to ampicillin (96.2%), ceftriaxone (78.3%), cefotaxime (78%), cefuroxime (78%) and ceftazidime (76.4%). MDR frequency of Enterobacteriaceae at Hawassa, Tikur Anbessa, Yekatit 12 and Dessie hospital was 95.1%, 93.2%, 87.3% and 67.7%, respectively. Carbapenem resistance was detected in 17.1% of K. pneumoniae (n = 111), 27.7% of E. cloacae (n = 22) and 58.8% of Acinetobacter baumannii (n = 34).ConclusionDiverse and emerging gram-negative bacterial etiologies of sepsis were identified. High multidrug resistance frequency was detected. Both on sepsis etiology types and MDR frequencies, substantial variation between hospitals was determined. Strategies to control MDR should be adapted to specific hospitals. Standard bacteriological services capable of monitoring emerging drug-resistant sepsis etiologies are essential for effective antimicrobial stewardship.
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Asrat, DanielAddis Ababa Univ, Coll Hlth Sci, Sch Med, Dept Microbiol Immunol & Parasitol, Addis Ababa, Ethiopia.
(author)
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Swedberg, GöteUppsala universitet,Institutionen för medicinsk biokemi och mikrobiologi(Swepub:uu)goteswed
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Hasan, Badrul,1984-Uppsala universitet,Institutionen för medicinsk biokemi och mikrobiologi(Swepub:uu)badha900
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Mekasha, AmhaAddis Ababa Univ, Coll Hlth Sci, Dept Pediat & Child Hlth, Addis Ababa, Ethiopia.
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Getahun, TadesseYekatit 12 Hosp, Med Coll, Addis Ababa, Ethiopia.
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Worku, MisganawHawassa Univ, Coll Med & Hlth Sci, Dept Gynecol Obstet, Hawassa, Ethiopia.
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Shimber, Eminet TesfayeHawassa Univ, Coll Med & Hlth Sci, Dept Emergency & Crit Care Med, Hawassa, Ethiopia.
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Getahun, SeidWollo Univ, Coll Med & Hlth Sci, Dept Internal Med, Dessie, Ethiopia.
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Ayalew, TsedaleWollo Univ, Coll Med & Hlth Sci, Dept Pediat & Child Hlth, Dessie, Ethiopia.
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Gizachew, BirhanWollo Univ, Coll Med & Hlth Sci, Dept Internal Med, Dessie, Ethiopia.
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Aseffa, AbrahamArmauer Hansen Res Inst, Addis Ababa, Ethiopia.
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Mihret, AdaneArmauer Hansen Res Inst, Addis Ababa, Ethiopia.;Addis Ababa Univ, Coll Hlth Sci, Sch Med, Dept Microbiol Immunol & Parasitol, Addis Ababa, Ethiopia.
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Uppsala universitetInstitutionen för medicinsk biokemi och mikrobiologi
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In:Antimicrobial Resistance and Infection Control: BioMed Central (BMC)11:12047-2994
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