Abstract:
Background
Extended-spectrum Beta-lactamase and Carbapenemase producing Enterobacteriaceae are
spreading among both hospitals and communities, with varied levels of prevalence. They are
considered as World Health Organization‘s most critical priority pathogens due to their high
resistance to a large number of antibiotics. Objective: Therefore, this study is aimed to
determine the prevalence and associated factors of Extended Spectrum Betalactamase and
carbapenemase producing Enterobacteriacae in the study area.
Methods: A hospital-based cross-sectional study design was implemented on 231
hospitalized patients using convenient sampling technique. Data collection was performed by
using a structured questionnaire. The standard bacteriological techniques were used for the
isolation and identification of bacterial species from stool, urine and sputum specimens
collected from the hospitalized patients. The modified Kirby-Bauer disc diffusion method for
screening, combination disk method and modified hodge test were used for confirming the
production of Extended Spectrum Betalactamase and carbapenemase by Enterobacteriaceae.
Data was entered by EPiData and analyzed using Statistical Package for Social Science
version 26. Then, Statistical significance was determined by the P-value <0.05.
Result: From 231 hospitalized patients, 72(31.2%) Enterobacteriaceae strains were isolated.
The overall proportion of Enterobacteriaceae that were Extended-Spectrum Beta-lactamase
producers, Carbapenemase-producers, and Multidrug-Resistant were 31.9%, 6.9%, and
72.2%, respectively. The most predominant Extended-Spectrum Beta-lactamase producer was
E.coli 13(56.5%), followed by K.pneumoniae 9(39%) and Citrobacter species 1(4.3%).
K.pneumoniae 3(60%), E.coli 1(20%) and Citrobacter species 1(20%) were carbapenemase
producers. Factors associated with ESBL producing Enterobacteriaceae were previous
hospitalization (P=0.04, AOR=4.326, 95% CI=1.059-17.677), other co-morbidity (P=0.04,
AOR=4.918, 95% CI=1.051-23.016), admission to surgical ward (P=0.02, AOR=4.058, 95%
CI=1.006-16.367), habit of handwashing (P=0.01, AOR=6.568, 95% CI=1.347-32.027) and
family income (P=0.01, AOR=6.244, 95% CI=1.448-26.924)
Conclusion: This study‘s overall proportion of Extended-Spectrum Beta-lactamase
producing Enterobacteriaceae and Multidrug Resistant Enterobacteriaceae was high.
Therefore, effective infection prevention and careful selection of empirical therapy were
recommended to control their spread in the study area.
