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Sepsis due to carbapenemase-producing and colistin-resistant Enterobacteriaceae is a global health threat. A multicenter study was conducted between October 2019 and September 2020 at four hospitals located in different parts of Ethiopia. From a total of 1,416 sepsis patients, blood culture was performed. Enterobacteriaceae were confirmed using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Carbapenem and colistin susceptibility testing was performed using disk diffusion, broth microdilution, and Etest strip. Enterobacteriaceae isolates (n = 301) were subjected to whole-genome sequencing using Illumina HiSeq 2500. SPAdes version 3.9 was used for genome assembly. Carbapenem and colistin resistance genes, chromosomal point mutations, sequence types, and plasmid replicons were identified using tools at the Center for Genomic Epidemiology. Phylogeny structure was constructed using CSI Phylogeny 1.4. Visualization of trees and metadata was done using iTOL v6.5.2. Among 301 Enterobacteriaceae, 22 Klebsiella pneumoniae, 2 Klebsiella variicola, and 3 Enterobacter cloacae isolates showed reduced susceptibility to meropenem (7% of tested isolates). bla(NDM-1), bla(NDM-5), and bla(OXA-181) were variants of carbapenemase genes detected. Co-occurrence of bla(NDM-5) and bla(OXA-181) was detected with 4 K. pneumoniae strains. K. pneumoniae and K. variicola showed chromosomal alterations of ompK36 and ompk37. Plasmid incompatibility (Inc) groups Col, IncC, IncHI, IncF, IncFII, IncR, and IncX3 were identified among carbapenem-resistant K. pneumoniae and E. cloacae isolates. Two mcr-9 genes were detected from Salmonella species and K. pneumoniae. The dissemination of carbapenemase-producing Enterobacteriaceae in all hospitals is worrying. Multiple carbapenemase genes were detected, with bla(NDM) variants the most frequent. The occurrence of colistin-resistant Enterobacteriaceae among sepsis patients is critical. Implementation of effectiv

Extended-spectrum beta-lactamases (ESBLs) and AmpC producing Enterobacteriaceae are public health threats. This study aims to characterize ESBL and AmpC producing Enterobacteriaceae isolated from sepsis patients. A multicenter study was conducted at four hospitals located in central (Tikur Anbessa and Yekatit 12), southern (Hawassa) and northern (Dessie) parts of Ethiopia. Blood culture was performed among 1416 sepsis patients. Enterobacteriaceae (n = 301) were confirmed using MALDI-TOF and subjected for whole genome sequencing using the Illumina (HiSeq 2500) system. The overall genotypic frequencies of ESBL and AmpC producing Enterobacteriaceae were 75.5% and 14%, respectively. The detection of ESBL producing Enterobacteriaceae at Hawassa, Yekatit 12, Tikur Anbessa and Dessie was 95%, 90%, 82% and 55.8%, respectively. The detection frequency of bla(CTX-M), bla(TEM) and bla(SHV) genes was 73%, 63% and 33%, respectively. The most frequently detected ESBL gene was bla(CTX-M-15) (70.4%). The common AmpC genes were bla(ACT) (n = 22) and bla(CMY) (n = 13). Of Enterobacteriaceae that harbored AmpC (n = 42), 71% were ESBL co-producers. Both bla(TEM-1B) (61.5%) and bla(SHV-187) (27.6%) were the most frequently detected variants of bla(TEM) and bla(SHV), respectively. The molecular epidemiology of ESBL producing Enterobacteriaceae showed high frequencies and several variants of ESBL and AmpC genes. Good antimicrobial stewardship and standard bacteriological laboratory services are necessary for the effective treatment of ESBL producing Enterobacteriaceae.

Demissew Shenkute,1 Melese Hailu Legese,2 Berhanu Yitayew,1 Asaye Mitiku,3 Getabalew Engidaye,4 Saba Gebremichael,5 Daniel Asrat,6 Yimtubezinash Woldeamanuel6 1Department of Medical Laboratory Science, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia; 2Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Medical Laboratory Science, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia; 4Department of Medical Laboratory Science, Debre Berhan Health Science College, Debre Berhan, Ethiopia; 5Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 6Department of Microbiology, Immunology, and Parasitology, College of Health Sciences Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Demissew Shenkute, Email demissewshen@gmail.comBackground: Gastrointestinal colonization rate of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) is the major risk factor for infection and dissemination of resistance clones in healthcare facilities. This study aimed to investigate the magnitude of the fecal carriage of ESBL-PE and associated factors among hospitalized patients at Debre Berhan Comprehensive Specialized Hospital, North Shoa, Amhara Regional State, Ethiopia.Methods: A hospital-based cross-sectional study was conducted among 383 hospitalized patients from November 2020 to March 2021. Stool sample or rectal swab was aseptically collected and cultured on different culture media for isolation of Enterobacteriaceae. Identification was done by conventional biochemical tests. Screening of extended-spectrum beta-lactamase (ESBL) production was done by using cefotaxime and ceftazidime and confirmed by the combination disk method. Data analysis was performed by Statistical Package for Social Sciences software version 25 and a P-value ≤ 0.05 was considered as statisti

Aminu Seman,1,2 Adane Mihret,1,2 Shemse Sebre,1,2 Tewachew Awoke,3 Biruk Yeshitela,2 Berhanu Yitayew,4 Abraham Aseffa,2 Daniel Asrat,1 Tamrat Abebe1 1Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 2Bacterial and Viral Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia; 3Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; 4Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, EthiopiaCorrespondence: Aminu Seman, Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, P.O. Box: 9086, Addis Ababa, Ethiopia, Tel +251 920 747 176, Email aminu.seman@aau.edu.et; aminumifta54@gmail.comBackground: Production of Extended spectrum beta-lactamase (ESBL) and Carbapenemase is the most common strategy for drug resistance in clinical isolates of Enterobacteriaceae. This study was conducted to determine the magnitude of ESBL and Carbapenemase production (CPE) among clinical isolates of Enterobacteriaceae causing bloodstream infections (BSI) in Ethiopia.Methods: A cross-sectional study was performed from September 2018 to January 2019 in Ethiopia. A total of 2397 BSI suspected patients were enrolled and blood culture was performed using a BacT/Alert instrument in combination with conventional methods for identification. After antimicrobial susceptibility test, phenotypic confirmation of ESBLs was done by combined disc-diffusion. Meanwhile carbapenemase production was done by modified carbapenem inactivation method. Multiplex PCR was conducted to detect the presence of blaCTX-M,blaSHV, blaTEM, blaKPC and blaNDM genes.Results: A total of 104 (4.3%) Enterobacteriaceae were isolated from 2397 BSI suspected patients. Klebsiella pneumoni

Carbapenemase-producing Aeromonas species are an emerging health threat. This study aimed to determine carbapenemase-mediated resistance among Aeromonas isolates from the Akaki river, Ethiopia during the dry and wet seasons in 2019-2020. Antimicrobial susceptibility to carbapenems and cephalosporins was determined and carbapenemase production was confirmed. Of 163 isolates, the majority were human pathogens Aeromonas caviae (62), Aeromonas hydrophila (33) and Aeromonas veronii (49). These isolates were resistant to carbapenem and cephalosporin antibiotics, with the highest resistance to cefotaxime 86 (59.7%), ertapenem 71 (49.3%) and imipenem 65 (45.1%). Resistance to carbapenem antibiotics varied between species, where most A. veronii 37 (75.5%) and A. hydrophila 28 (84.8%) were resistant to imipenem, whereas all A.caviae were sensitive. A. veronii, A. caviae and A. hydrophila resistance to meropenem was 31 (63.3%), 3 (4.8%) and 19 (57.6%), respectively. Of isolates resistant to carbapenem, 82.1% A. hydrophila and 94.4% A. veronii were carbapenemase producers. Cephalosporin resistance also varied among the different species. The highest resistance to carbapenem antibiotics was in isolates collected during the wet season (p<0.05); however, it was not consistent across all classes of antibiotics tested. The rivers in megacities could be reservoirs of carbapenemase-producing Aeromonas spp., Funding agency:Addis Ababa University

Abel Abera Negash,1,2 Daniel Asrat,2 Workeabeba Abebe,3 Abraham Aseffa,1 Mario Vaneechoutte4 1Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia; 2Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Pediatrics and Child Health, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia; 4Laboratory Bacteriology Research, Department of Diagnostic Sciences, Faculty of Medicine & Health Sciences, Ghent University, Ghent, BelgiumCorrespondence: Abel Abera NegashArmauer Hansen Research Institute (AHRI), P.O. Box 1005, Addis Ababa, EthiopiaEmail abelaberan@gmail.comBackground: In several countries, introduction of the pneumococcal conjugate vaccine (PCV) has led to a decline in antimicrobial-resistant pneumococcal disease but has also resulted in a concomitant increase in antimicrobial-resistant, non-vaccine serotypes of Streptococcus pneumoniae. We sought to determine the magnitude of penicillin and macrolide resistance among pneumococcal serotypes and the mechanisms of macrolide resistance in Ethiopia, 5 years after the introduction of PCV10 in the country.Methods: Susceptibility to penicillin and erythromycin of 119 pneumococcal isolates collected from pediatric patients aged 0– 15 years in Addis Ababa, Ethiopia, was tested using disc diffusion, and minimum inhibitory concentration (MIC) was also determined by Etest. Pneumococcal serotypes were determined by sequencing the cpsB gene and using Quellung reaction. Polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism analysis were used to detect and differentiate the macrolide resistance genes erm(B), mef(A), and mef(B).Results: Among the 119 isolates, 2.5% (3/119) were resistant to penicillin, while 58% (69/119) were intermediate. Resistance to erythromycin was observed in 33.6% (40/119) of the isolates with the highest level of resistance among isolates from middle ear d

Yerega Belete,1 Daniel Asrat,2 Yimtubezinash Woldeamanuel,2 Gebeyehu Yihenew,1 Addisu Gize1 1Department of Microbiology, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia; 2Department of Microbiology, Immunology And Parasitology, Faculty of Medicine, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Yerega BeleteSt. Paul’s Hospital Millennium Medical College, Addis Ababa, EthiopaTel +251920735677Email yereb2000@gmail.comBackground: Urinary tract infection (UTI) is a common and important clinical problem in pediatrics. Recurrent UTIs may lead to renal scarring, hypertension, and end-stage renal dysfunction later in life. The objective of the study was to determine bacterial profile and antimicrobial susceptibility pattern of urinary tract infections (UTIs) among children attending Felege Hiwot Referral Hospital (FHRH).Methods: A cross-sectional study was conducted from February 2013 to May 2013 among children 5–15 years of age with symptoms of UTI. Samples were processed for culture and identification. Antimicrobial susceptibility was done for positive urine cultures by the Kirby-Bauer’s disk diffusion method based on standards of the Clinical Laboratory Standard Institute (CLSI). Data were entered into Epi-data version 3.2.1 and exported to the Statistical Package for the Social Science (SPSS) version 20 statistical software. Fisher’s exact test and binary logistic regression test results were used.Results: A total of 259 urine samples were collected from children with UTI. The result revealed 41 (15.8%) samples had significant bacteriuria, among which the most prevalent pathogen was E. coli 14 (34.1%) followed by Pseudomonas species. Gram-negative bacteria showed high level of sensitivity to ciprofloxacin (70), norfloxacin (63.4%) and ceftriaxone (60%), whereas the level of resistance was high to ampicillin (80%) and nitrofurantoin (70%). Gram-positive isolates showed high sensitivity