High Prevalence of Faecal Carriage of ESBL-Producing Enterobacteriaceae Among Children in Dar Es Salaam, Tanzania

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2016 Dec 10

PMID 27936054

Citations 59

Authors

Marit G Tellevik

Bjorn Blomberg

Oyvind Kommedal

Samuel Y Maselle

Nina Langeland

Sabrina J Moyo

Affiliations

Soon will be listed here.

Abstract

Background: Faecal carriage of ESBL-producing bacteria is a potential risk for transmission and infection. Little is known about faecal carriage of antibiotic resistance in Tanzania. This study aimed to investigate the prevalence of faecal carriage of ESBL-producing Enterobacteriaceae and to identify risk factors for carriage among young children in Tanzania.

Methodology/principal Findings: From August 2010 to July 2011, children below 2 years of age were recruited in Dar es Salaam, including healthy community children (n = 250) and children hospitalized due to diarrhoea (n = 250) or other diseases (n = 103). ChromID ESBL agar and ChromID CARBA SMART agar were used for screening. Antimicrobial susceptibility testing was performed by the disk diffusion method. ESBL genotypes were identified by Real-Time PCR and sequencing. The overall prevalence of ESBL carriage was 34.3% (207/ 603). The prevalence of ESBL carriage was significantly higher among hospitalized children (50.4%), compared to community children (11.6%; P < 0.001; OR = 7.75; 95% CI: 4.99-12.03). We found high prevalence of Multidrug-resistance (94%) among Escherichia coli and Klebsiella pneumoniae isolates. No resistance to carbapenems was detected. For the majority of isolates (94.7%) we detected a blaCTX-M-15-like gene. In addition, the plasmid mediated AmpC beta-lactamase CMY-2 was detected for the first time in Tanzania. ESBL prevalence was significantly higher among HIV positive (89.7%) than HIV negative (16.9%) children (P = 0.001; OR = 9.99; 95% CI: 2.52-39.57). Use of antibiotics during the past 14 days and age below 1 year was also associated with ESBL carriage.

Conclusions/significance: We report a high rate of faecal carriage of ESBL-producing Enterobacteriaceae among children below 2 years of age in Tanzania, particularly those with HIV-infection. Resistance to a majority of the available antimicrobials commonly used for children in Tanzania leaves few treatment options for infections when caused by these bacteria.

Citing Articles

Fecal carriage of carbapenemase and AmpC-β-lactamase producers among extended spectrum β-Lactamase-producing E. coli and Klebsiella spp. isolates in patients attending hospitals.

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PMID: 39849346 PMC: 11760080. DOI: 10.1186/s12879-025-10506-4.

High prevalence of fecal carriage of extended-spectrum beta-lactamase producing among patients with urinary tract infections in rural Tanzania.

Macha M, Qi W, Seiffert S, Bosch A, Kohler P, Urassa H Front Microbiol. 2025; 15():1517182.

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Fecal carriage of ESBL-producing E. coli and genetic characterization in rural children and livestock in the Somali region, Ethiopia: a one health approach.

Muhummed A, Alemu A, Hosch S, Osman Y, Tschopp R, Yersin S Antimicrob Resist Infect Control. 2024; 13(1):148.

PMID: 39695886 PMC: 11656975. DOI: 10.1186/s13756-024-01502-5.

Faecal carriage of extended-spectrum beta-lactamase and carbapenemase-producing enterobacterales among HIV patients at Jimma Medical Center, Southwest Ethiopia.

Befikadu D, Tamrat R, Garedo A, Beyene G, Gudina E, Gashaw M BMC Microbiol. 2024; 24(1):459.

PMID: 39506640 PMC: 11539523. DOI: 10.1186/s12866-024-03596-8.

Paediatric Enterobacteriaceae infections in hospitalised children in Durban, KwaZulu-Natal.

Krishinchand H, Naidoo K, Mahabeer P, Archary M S Afr J Infect Dis. 2024; 36(1):279.

PMID: 39376941 PMC: 11457515. DOI: 10.4102/sajid.v36i1.279.

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