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ORIGINAL ARTICLE
Year : 2021  |  Volume : 24  |  Issue : 1  |  Page : 1-9

Carbapenem-resistant Enterobacteriaceae infections among patients admitted to intensive care units in Kano, Nigeria


1 Department of Medical Microbiology and Parasitology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
2 Department of Community Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
3 Department of Medical Microbiology, Usmanu Danfodio University/Teaching Hospital, Sokoto, Nigeria
4 Department of Global Health, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, Cape Town, South Africa
5 Department of Medical Microbiology, Ahmadu Bello University, Zaria, Nigeria
6 Multi-drug Resistant Tuberculosis Unit, Infectious Diseases Hospital, Kano, Nigeria
7 Department of Medical Microbiology, Aminu Kano Teaching Hospital, Kano, Nigeria
8 Department of Anaesthesiology and Intensive Care, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
9 Department of Medical Microbiology, University of Maiduguri/University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria

Correspondence Address:
Dr. Rabiu Ibrahim Jalo
Department of Community Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano
Nigeria
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DOI: 10.4103/smj.smj_14_20

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Background: Globally, intensive care units (ICUs) are encountering emergence and spread of antibiotic-resistant pathogens, and for some pathogens, there are few therapeutic options available. Objectives: The study assessed prevalence, susceptibility pattern, and risk factors of carbapenem-resistant Enterobacteriaceae (CRE) infections among ICU patients in Kano, Nigeria. Materials and Methods: A descriptive cross-sectional study was used to study 190 patients admitted to the ICUs of two tertiary hospitals in Kano. Antibiotic susceptibility of isolated organisms was determined by disc diffusion technique. Suspected carbapenemase producers were further subjected to the modified Hodge test (MHT) method for confirmation. Results: A total of 76 out of the 190 samples yielded clinical isolates of Enterobacteriaceae as follows: 34 (44.7%) Escherichia coli, 19 (25%) Klebsiella pneumoniae, 3 (3.9%) Proteus mirabilis, 4 (5.3%) Enterobacter aerogenes, 3 (3.9%) Proteus vulgaris, 2 (2.6%) Citrobacter freundii, 2 (2.6%) Klebsiella ozaenae, 2 (2.6%) Klebsiella oxytoca, 2 (2.6%) Salmonella subsp. 3b, 2 (2.6%) Enterobacter agglomerans, 2 (2.6%) Enterobacter cloacae, and 1 (1.3%) Serratia odorifera. Screening the Enterobacteriaceae-positive samples for carbapenem resistance using ertapenem disc (10 μg) showed 8 samples (10.5%) as resistant while MHT gave a carbapenem resistance prevalence of 7.9% (6 out of 76). Based on multiplex polymerase chain reaction; the distributions of genotypes of the carbapenemase producers were as follows: Verona Integron Metallo-beta-lactamase (VIM) genes only (4 [50%]) New Delhi Metallo-beta-lactamase (NDM) genes only (2 [25%]), and 1 (12.5%) had Klebsiella pneumoniae carbapenemase (KPC) and VIM gene coexisting. Surgical procedure (P = 0.009) and history of recent admission (P = 0.001) were found to be risk factors for CRE. Conclusion: The study provided evidence of the presence of CRE infections among patients admitted to ICUs in the study centers. This underscores the need for effective infection prevention and control measures to avoid the spread of CRE in hospital setting.


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