High prevalence of fecal carriage of extended-spectrum beta-lactamase producing Enterobacterales among patients with urinary tract infections in rural Tanzania
IntroductionThe global rise of extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) challenges resource-limited countries with insufficient laboratory infrastructure. This study investigates fecal carriage and risk factors for ESBL-PE and carbapenemase-producing organisms among pati...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2024.1517182/full |
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| author | Magreth Erick Macha Magreth Erick Macha Magreth Erick Macha Weihong Qi Salome N. Seiffert Anja Bösch Philipp Kohler Honorathy Msami Urassa Sabine Haller Erin West Maja Weisser Rohacek Maja Weisser Rohacek Maja Weisser Rohacek Baharak Babouee Flury Baharak Babouee Flury Baharak Babouee Flury Baharak Babouee Flury |
| author_facet | Magreth Erick Macha Magreth Erick Macha Magreth Erick Macha Weihong Qi Salome N. Seiffert Anja Bösch Philipp Kohler Honorathy Msami Urassa Sabine Haller Erin West Maja Weisser Rohacek Maja Weisser Rohacek Maja Weisser Rohacek Baharak Babouee Flury Baharak Babouee Flury Baharak Babouee Flury Baharak Babouee Flury |
| author_sort | Magreth Erick Macha |
| collection | DOAJ |
| description | IntroductionThe global rise of extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) challenges resource-limited countries with insufficient laboratory infrastructure. This study investigates fecal carriage and risk factors for ESBL-PE and carbapenemase-producing organisms among patients with urinary tract infection (UTI) in rural Tanzania.MethodsThis cross-sectional study was conducted at St. Francis Regional Referral Hospital, Ifakara, Tanzania, from October 2021 to August 2023, involving 326 UTI patients. Demographic data and resistance risk factors were collected via structured questionnaires. Stool samples collected pre-antibiotic treatment were screened for ESBL-PE and carbapenemase locally. Positive samples underwent further analysis in Switzerland using MALDI-ToF, Vitek MS, and whole-genome sequencing. Multivariable analysis assessed predictors associated with ESBL-PE carriage for risk factors with p < 0.05.ResultsWe enrolled 326 UTI patients (median age: 35.5 years, range: 25–52) and 189 (58.0%) were females. Fecal ESBL-PE colonization was detected in 70.9% of patients, predominantly E. coli (62.8%) and K. pneumoniae (33.0%). Whole-genome sequencing identified diverse phylogroups and sequence types, with CTX-M-15 being the most common ESBL gene. IncF plasmids were the primary carriers. Younger age (aOR: 0.98, 95% CI: 0.97–0.99; p = 0.0239) and inpatient status (aOR: 1.77, 95% CI: 1.08–2.91; p = 0.0036) were significant risk factors for ESBL-PE carriage.ConclusionThe high prevalence of ESBL-PE fecal carriage in rural Tanzania highlights the need for improved infection control and further research into community transmission dynamics. |
| format | Article |
| id | doaj-art-45b79f827e6e471597674def5cfe2d7e |
| institution | Kabale University |
| issn | 1664-302X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Microbiology |
| spelling | doaj-art-45b79f827e6e471597674def5cfe2d7e2025-01-06T05:13:21ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2025-01-011510.3389/fmicb.2024.15171821517182High prevalence of fecal carriage of extended-spectrum beta-lactamase producing Enterobacterales among patients with urinary tract infections in rural TanzaniaMagreth Erick Macha0Magreth Erick Macha1Magreth Erick Macha2Weihong Qi3Salome N. Seiffert4Anja Bösch5Philipp Kohler6Honorathy Msami Urassa7Sabine Haller8Erin West9Maja Weisser Rohacek10Maja Weisser Rohacek11Maja Weisser Rohacek12Baharak Babouee Flury13Baharak Babouee Flury14Baharak Babouee Flury15Baharak Babouee Flury16St. Francis University College of Health and Allied Sciences, Ifakara, TanzaniaMedical Research Center, Kantonsspital St. Gallen, St. Gallen, SwitzerlandGraduate School for Cellular and Biomedical Sciences, University of Bern, Bern, SwitzerlandFunctional Genomics Center Zurich, University of Zürich/ETH Zürich, Zürich, SwitzerlandDivision of Human Microbiology, Centre for Laboratory Medicine, St. Gallen, SwitzerlandMedical Research Center, Kantonsspital St. Gallen, St. Gallen, SwitzerlandDivision of Infectious Diseases, Infection Prevention, and Travel Medicine, Kantonsspital St. Gallen, St. Gallen, SwitzerlandSt. Francis Regional Referral Hospital, Ifakara, TanzaniaDivision of Infectious Diseases, Infection Prevention, and Travel Medicine, Kantonsspital St. Gallen, St. Gallen, SwitzerlandClinical Trials Unit, Kantonsspital St. Gallen, St. Gallen, SwitzerlandDivision of Infectious Diseases, University Hospital Basel, Basel, Switzerland0Swiss Tropical and Public Health Institute, Allschwil, Switzerland1Ifakara Health Institute, Ifakara, TanzaniaMedical Research Center, Kantonsspital St. Gallen, St. Gallen, SwitzerlandDivision of Infectious Diseases, Infection Prevention, and Travel Medicine, Kantonsspital St. Gallen, St. Gallen, SwitzerlandClinical Trials Unit, Kantonsspital St. Gallen, St. Gallen, Switzerland2Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, SwitzerlandIntroductionThe global rise of extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) challenges resource-limited countries with insufficient laboratory infrastructure. This study investigates fecal carriage and risk factors for ESBL-PE and carbapenemase-producing organisms among patients with urinary tract infection (UTI) in rural Tanzania.MethodsThis cross-sectional study was conducted at St. Francis Regional Referral Hospital, Ifakara, Tanzania, from October 2021 to August 2023, involving 326 UTI patients. Demographic data and resistance risk factors were collected via structured questionnaires. Stool samples collected pre-antibiotic treatment were screened for ESBL-PE and carbapenemase locally. Positive samples underwent further analysis in Switzerland using MALDI-ToF, Vitek MS, and whole-genome sequencing. Multivariable analysis assessed predictors associated with ESBL-PE carriage for risk factors with p < 0.05.ResultsWe enrolled 326 UTI patients (median age: 35.5 years, range: 25–52) and 189 (58.0%) were females. Fecal ESBL-PE colonization was detected in 70.9% of patients, predominantly E. coli (62.8%) and K. pneumoniae (33.0%). Whole-genome sequencing identified diverse phylogroups and sequence types, with CTX-M-15 being the most common ESBL gene. IncF plasmids were the primary carriers. Younger age (aOR: 0.98, 95% CI: 0.97–0.99; p = 0.0239) and inpatient status (aOR: 1.77, 95% CI: 1.08–2.91; p = 0.0036) were significant risk factors for ESBL-PE carriage.ConclusionThe high prevalence of ESBL-PE fecal carriage in rural Tanzania highlights the need for improved infection control and further research into community transmission dynamics.https://www.frontiersin.org/articles/10.3389/fmicb.2024.1517182/fullfecal carriageextended-spectrum beta-lactamaseenterobacteralesurinary tract infectionsrural Tanzania |
| spellingShingle | Magreth Erick Macha Magreth Erick Macha Magreth Erick Macha Weihong Qi Salome N. Seiffert Anja Bösch Philipp Kohler Honorathy Msami Urassa Sabine Haller Erin West Maja Weisser Rohacek Maja Weisser Rohacek Maja Weisser Rohacek Baharak Babouee Flury Baharak Babouee Flury Baharak Babouee Flury Baharak Babouee Flury High prevalence of fecal carriage of extended-spectrum beta-lactamase producing Enterobacterales among patients with urinary tract infections in rural Tanzania Frontiers in Microbiology fecal carriage extended-spectrum beta-lactamase enterobacterales urinary tract infections rural Tanzania |
| title | High prevalence of fecal carriage of extended-spectrum beta-lactamase producing Enterobacterales among patients with urinary tract infections in rural Tanzania |
| title_full | High prevalence of fecal carriage of extended-spectrum beta-lactamase producing Enterobacterales among patients with urinary tract infections in rural Tanzania |
| title_fullStr | High prevalence of fecal carriage of extended-spectrum beta-lactamase producing Enterobacterales among patients with urinary tract infections in rural Tanzania |
| title_full_unstemmed | High prevalence of fecal carriage of extended-spectrum beta-lactamase producing Enterobacterales among patients with urinary tract infections in rural Tanzania |
| title_short | High prevalence of fecal carriage of extended-spectrum beta-lactamase producing Enterobacterales among patients with urinary tract infections in rural Tanzania |
| title_sort | high prevalence of fecal carriage of extended spectrum beta lactamase producing enterobacterales among patients with urinary tract infections in rural tanzania |
| topic | fecal carriage extended-spectrum beta-lactamase enterobacterales urinary tract infections rural Tanzania |
| url | https://www.frontiersin.org/articles/10.3389/fmicb.2024.1517182/full |
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