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Extended Spectrum Beta-Lactamase Production and Multidrug-Resistant Enterobacterales Among Patients With Symptoms of
Tamirat Tamiru1, Yordanos Getachew1,2, Sami Sebri1
1Department of Microbiology Laboratory, Wudassie Advanced Medical Laboratory, Addis Ababa, Ethiopia.
Background:
Urinary tract infections (UTIs) are one of the commonly encountered infectious diseases globally, affecting approximately 150 million individuals each year. The rise of multidrug-resistant (MDR) particularly extended spectrum beta-lactamase (ESBL) producing Enterobacterales has made the management of UTI more difficult and this is becoming a common public health concern worldwide. The study is aimed at assessing the prevalence, antimicrobial resistance, and extended-spectrum beta-lactamase-producing Enterobacterales among patients with symptoms of UTI at Wudassie Advanced Medical Laboratory, Addis Ababa, Ethiopia.
Methods:
A laboratory based cross-sectional study was conducted from April to July 2025. A total of 502 urine specimens from UTI suspected patients were included in the study. The identification of Enterobacterales was done using MALDI-TOF MS. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion technique. Combined disc test (CDT) was used for confirmation of ESBL producing Enterobacterales. Data was entered in Epidata version 4.6 and analyzed using SPSS Version 27.
Result:
Among 502 patients presenting with clinical symptoms of UTI, 29.4% (148/502) had positive culture for Enterobacterales. The predominant species isolated were Escherichia coli 103 (69.6%) and Klebsiella pneumoniae 25 (16.8%). The prevalence of extended spectrum β-lactamases-producing Enterobacterales (ESBLs-E) was 65.5% (97/148: 95% CI: 57.8%-73.2%). The highest proportion (92.3%) of ESBL-producing isolate among inpatients was K. pneumoniae. MDR was also detected in 82.4% of the isolates from this study.
Conclusion:
The findings highlight a high prevalence of MDR- and ESBL-producing Enterobacterales causing UTI in Ethiopia. This finding emphasizes a critical need to implement comprehensive surveillance systems in hospital settings to enable the detection and tracking of MDR Enterobacterales. Future research needs to be conducted to direct policies on the implementation of antibiotic stewardship programs.
Insights
A study in Ethiopia found a high prevalence of multidrug-resistant (MDR) and extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales causing urinary tract infections (UTIs). This highlights the urgent need for surveillance and antibiotic stewardship programs.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Urinary tract infections (UTIs) are a global health concern, affecting millions annually.
- The increasing prevalence of multidrug-resistant (MDR) and extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales complicates UTI management.
- Ethiopia faces a growing challenge with these resistant pathogens in UTIs.
Purpose of the Study:
- To determine the prevalence of Enterobacterales in patients with UTI symptoms.
- To assess the antimicrobial resistance patterns of isolated Enterobacterales.
- To identify the prevalence of ESBL-producing Enterobacterales in Addis Ababa, Ethiopia.
Main Methods:
- A cross-sectional laboratory study involving 502 urine specimens from suspected UTI patients.
- Enterobacterales identification using MALDI-TOF MS.
- Antimicrobial susceptibility testing via Kirby-Bauer disc diffusion and ESBL confirmation using combined disc test.
Main Results:
- Enterobacterales were identified in 29.4% of samples, with Escherichia coli and Klebsiella pneumoniae being predominant.
- A high prevalence of ESBL-producing Enterobacterales (65.5%) and MDR (82.4%) was observed.
- Klebsiella pneumoniae showed a high proportion (92.3%) of ESBL production among inpatients.
Conclusions:
- The study reveals a significant burden of MDR and ESBL-producing Enterobacterales causing UTIs in Ethiopia.
- There is a critical need for enhanced surveillance systems in healthcare settings to monitor resistant bacteria.
- Future research should guide the implementation of effective antibiotic stewardship programs.
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