Assistant Researcher, Ethiopian Public Health Institute


Aimed to determine the prevalence MDR and ESBLs in Addis Ababa, Ethiopia

Background: The global emergence and spread of antimicrobial resistance, specifically Extended-spectrum Beta-lactamases (ESBLs) producing Enterobacteriaceae, have been threatening the ability to treat an infection. Hence, our study aimed to determine the prevalence of multi-drug resistance (MDR) and ESBLs producing Enterobacteriaceae (ESBLs-E) from different clinical specimens in Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted from January 1 to May 30, 2017. A total of 426 Enterobacteriaceae isolates were identified from different clinical specimens; 272 from urine, 90 from blood, 40 from pus, 11 from body fluids, 6 from sputum, 3 from ear discharge, 2 from eye discharge and 2 from cerebrospinal fluid (CSF). The isolates were collected from four bacteriology laboratories using tryptose soya broth with 20% glycerol. Fresh colonies of the isolates were recovered using MacConkey and 5% sheep blood agar plate. Antimicrobial susceptibility testing was performed on Muller Hinton agar (MHA). All Enterobacteriaceae were screened for ESBLs production using cefotaxime and ceftazidime as per Clinical and Laboratory Standards Institute (CLSI) guideline. Each ESBLs specious Enterobacteriaceae were confirmed by combination disk test (CDT). Data was entered and analyzed by using SPSS version20. Result: The most frequent Enterobacteriaceae were E. coli 228 (53.5%) and K. pneumoniae 103 (24.1 %). The magnitude of ESBLs-E was 246 (57.7%). The highest frequencies of ESBLs-E were observed in blood specimen (84.4%) and the highest ESBLs production was observed in K. pneumoniae (85.4%). Highest resistance level was seen to sulfamethoxazole-trimethoprim (77.0%), augmentin (71.6%), cefotaxime (62.2%), cefepime (60.3) and ceftazidime (60.8%). The resistance to meropenem, amikacin and cefoxitin were 5.2%, 13.8%, and 25.1% respectively. The overall magnitude of multi-drug resistance (MDR) level was 68.3%. Of ESBLs-E, 96.3% of them were MDR. Conclusion: There was a high prevalence of ESBLs-E and MDR isolate in Addis Ababa. Most of ESBLs-E was isolated primarily in blood and urine. The highest ESBLs production was observed among K. pneumoniae. Resistance to multiple classes of antibiotics was observed among ESBLs producers than the non ESBLs producer. Hence, strong infection control strategies must be implemented in the hospitals of the country.