Browsing by Author "Silago, Vitus"

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Existence of multiple ESBL genes among phenotypically conﬁrmed ESBL producing klebsiella pneumoniae and escherichia coli concurrently isolated from clinical, colonization and contamination samples from neonatal units at Bugando Medical Center, Mwanza, Tanzania
(MDPI, 2021) Silago, Vitus; Kovacs, Dory; Samson, Happyness; Seni, Jeremiah; Matthews, Louise; Oravcová, Katarina; Lupindu, Athumani M.; Hoza, Abubakar S.; Mshana, Stephen E.
The proportions and similarities of extended-spectrum β-lactamase (ESBL) producing K. pneumoniae (ESBL-KP) and E. coli (ESBL-EC) carrying multiple ESBL genes is poorly known at our setting. This study investigated the existence of multiple ESBL genes (blaCTX-M, blaTEM, and blaSHV) among ESBL-KP and ESBL-EC concurrently isolated from clinical, colonization, and contamination samples from neonatology units in Mwanza-Tanzania. Twenty and 55 presumptive ESBL-EC and ESBL-KP, respectively, from a previous study archived at−80 ◦C were successfully recovered for this study. Isolates were screened and conﬁrmed for production of ESBLs by phenotypic methods followed by multiplex PCR assay to determine ESBL genes. All (100%) and 97.3% of presumptive ESBL isolates were phenotypically conﬁrmed by Clinical and Laboratory Standards Institute (CLSI) and modiﬁed double-disc synergy methods, respectively. About 93.3% (70/75) of phenotypically conﬁrmed ESBL isolates had at least one ESBL gene, whereby for 62.9% (44/70), all ESBL genes (blaCTX-M, blaTEM, and blaSHV) were detected. Eight pairs of ESBL bacteria show similar patterns of antibiotics susceptibility and ESBL genes. ESBL-KP and ESBL-EC, concurrently isolated from clinical, colonization and contamination samples, harbored multiple ESBL genes. Further, eight pairs of ESBL isolates had similar patterns of antibiotics susceptibility and ESBL genes, suggesting transmission of and/or sharing of mobile genetic elements (MGEs) among ESBL-KP and ESBL-EC.
Multidrug-resistant uropathogens causing community acquired urinary tract infections among patients attending health facilities in Mwanza and Dar es salaam, Tanzania
(MDPI, 2022) Silago, Vitus; Moremi, Nyambura; Mtebe, Majigo; Komba, Erick; Masoud, Salim; Mgaya, Fauster X.; Mirambo, Mariam M.; Nyawale, Helmut A.; Mshana, Stephen E.; Matee, Mecky Isaac
In low-income countries, the empirical treatment of urinary tract infections (UTIs) without laboratory confirmation is very common, especially in primary health facilities. This scenario often leads to unnecessary and ineffective antibiotic prescriptions, prompting the emergence and spread of antimicrobial resistance. We conducted this study to examine the antibiogram of uropathogens causing community-acquired urinary tract infections among outpatients attending selected health facilities in Tanzania. Method: This was a cross-sectional health centre-based survey conducted for a period of five months, from July to November 2021, in the Mwanza and Dar es Salaam regions in Tan- zania. We enrolled consecutively a total of 1327 patients aged between 2 and 96 years with a median [IQR] age of 28 [22–39] from Dar es Salaam (n = 649) and Mwanza (n = 678). Results: Significant bac- teriuria was observed in 364 (27.4% [95%CI: 25.0–29.9]) patients, from whom 412 urinary pathogens were isolated. Gram-negative bacteria contributed to 57.8% (238) of the 412 uropathogens isolated, of which 221 were Enterobacterales, and Escherichia coli was the most frequent. Staphylococcus aureus and Staphylococcus haemolyticus were the most frequently isolated among Gram-positive uropathogens (n = 156). Generally, resistance among Escherichia coli ranged from 0.7% (meropenem) to 86.0% (ampi- cillin) and from 0.0% (meropenem) to 75.6% (ampicillin) in other Enterobacterales. Moreover, about 45.4% (108) of Enterobacterales and 22.4% (35) of Gram-positive bacteria were multidrug resistant (MDR), p = 0.008. We observed 33 MDR patterns among Gram-negative bacteria, predominantly AMP-CIP-TCY (23/108; 21.3%), and 10 MDR patterns among Gram-positive bacteria, most com- monly CIP-GEN-TCY (22/35; 62.9%). Conclusion: the presence of a high number of wide-ranging uropathogens that are multidrug resistant to a variety of antibiotics points to the need to strengthen the laboratory diagnostic systems for the regular surveillance of the antimicrobial resistance of uropathogens to guide and update empirical treatment guidelines.