Colonisation with extended spectrum beta-lactamase producing and carbapenem-resistant enterobacterales in children admitted to a paediatric referral hospital in South Africa

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dc.contributor.advisorEley, Brian
dc.contributor.advisorNuttall, James
dc.contributor.authorOgunbosi, Babatunde Oluwatosin
dc.date.accessioned2021-02-18T13:53:01Z
dc.date.available2021-02-18T13:53:01Z
dc.date.issued2020
dc.date.updated2021-02-18T13:50:08Z
dc.description.abstractIntroduction: There are few studies describing colonisation with extended spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) and carbapenem-resistant Enterobacterales (CRE) among children in subSaharan Africa. Colonisation often precedes infection and multi-drug-resistant Enterobacterales are important causes of invasive infection. Methods: In this prospective cross-sectional study, conducted between April and June 2017, 200 children in a tertiary academic hospital were screened by rectal swab for EBSL-PE and CRE. The resistance-conferring genes were identified using polymerase chain reaction technology. Risk factors for colonisation were also evaluated. Results: Overall, 48% (96/200) of the children were colonised with at least one ESBL-PE, 8 of these with 2 ESBLPE, and one with a CRE (0.5%, 1/200). Common colonising ESBL-PE were Klebsiella pneumoniae (62.5%, 65/104) and Escherichia coli (34.6%, 36/104). The most frequent ESBL-conferring gene was blaCTX-M in 95% (76/80) of the isolates. No resistance- conferring gene was identified in the CRE isolate (Enterobacter cloacae). Most of the Klebsiella pneumoniae isolates were susceptible to piperacillin/tazobactam (86.2%) and amikacin (63.9%). Similarly, 94.4% and 97.2% of the Escherichia coli isolates were susceptible to piperacillin/tazobactam and amikacin, respectively. Hospitalisation for more than 7 days before study enrolment was associated with ESBL-PE colonisation. Conclusion: Approximately half of hospitalised children in this study were colonised with ESBL-PE. This highlights the need for improved infection prevention and control practices to limit the dissemination of these microorganisms.
dc.identifier.apacitationOgunbosi, B. O. (2020). <i>Colonisation with extended spectrum beta-lactamase producing and carbapenem-resistant enterobacterales in children admitted to a paediatric referral hospital in South Africa</i>. (). ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. Retrieved from http://hdl.handle.net/11427/32901en_ZA
dc.identifier.chicagocitationOgunbosi, Babatunde Oluwatosin. <i>"Colonisation with extended spectrum beta-lactamase producing and carbapenem-resistant enterobacterales in children admitted to a paediatric referral hospital in South Africa."</i> ., ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2020. http://hdl.handle.net/11427/32901en_ZA
dc.identifier.citationOgunbosi, B.O. 2020. Colonisation with extended spectrum beta-lactamase producing and carbapenem-resistant enterobacterales in children admitted to a paediatric referral hospital in South Africa. . ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. http://hdl.handle.net/11427/32901en_ZA
dc.identifier.ris TY - Master Thesis AU - Ogunbosi, Babatunde Oluwatosin AB - Introduction: There are few studies describing colonisation with extended spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) and carbapenem-resistant Enterobacterales (CRE) among children in subSaharan Africa. Colonisation often precedes infection and multi-drug-resistant Enterobacterales are important causes of invasive infection. Methods: In this prospective cross-sectional study, conducted between April and June 2017, 200 children in a tertiary academic hospital were screened by rectal swab for EBSL-PE and CRE. The resistance-conferring genes were identified using polymerase chain reaction technology. Risk factors for colonisation were also evaluated. Results: Overall, 48% (96/200) of the children were colonised with at least one ESBL-PE, 8 of these with 2 ESBLPE, and one with a CRE (0.5%, 1/200). Common colonising ESBL-PE were Klebsiella pneumoniae (62.5%, 65/104) and Escherichia coli (34.6%, 36/104). The most frequent ESBL-conferring gene was blaCTX-M in 95% (76/80) of the isolates. No resistance- conferring gene was identified in the CRE isolate (Enterobacter cloacae). Most of the Klebsiella pneumoniae isolates were susceptible to piperacillin/tazobactam (86.2%) and amikacin (63.9%). Similarly, 94.4% and 97.2% of the Escherichia coli isolates were susceptible to piperacillin/tazobactam and amikacin, respectively. Hospitalisation for more than 7 days before study enrolment was associated with ESBL-PE colonisation. Conclusion: Approximately half of hospitalised children in this study were colonised with ESBL-PE. This highlights the need for improved infection prevention and control practices to limit the dissemination of these microorganisms. DA - 2020 DB - OpenUCT DP - University of Cape Town KW - child health LK - https://open.uct.ac.za PY - 2020 T1 - Colonisation with extended spectrum beta-lactamase producing and carbapenem-resistant enterobacterales in children admitted to a paediatric referral hospital in South Africa TI - Colonisation with extended spectrum beta-lactamase producing and carbapenem-resistant enterobacterales in children admitted to a paediatric referral hospital in South Africa UR - http://hdl.handle.net/11427/32901 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/32901
dc.identifier.vancouvercitationOgunbosi BO. Colonisation with extended spectrum beta-lactamase producing and carbapenem-resistant enterobacterales in children admitted to a paediatric referral hospital in South Africa. []. ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2020 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/32901en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Paediatrics and Child Health
dc.publisher.facultyFaculty of Health Sciences
dc.subjectchild health
dc.titleColonisation with extended spectrum beta-lactamase producing and carbapenem-resistant enterobacterales in children admitted to a paediatric referral hospital in South Africa
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMPhil
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