Epidemiology of XXXX Resistance among Multi-drug Resistant Enterobacteriaceae in Uganda.

@entity1 @entity146 @entity2893 @entity2277 @entity2888
BACKGROUND: Multi-drug resistant (MDR) Enterobacteriaceae are on the increase worldwide and their spread has become a global challenge. Escalating the challenge is the possibility that many of these are Carbapenemase-producing Enterobacteriaceae (CPE). This further complicates @entity1 management. The magnitude of MDR-CPE in many developed settings has been reported, however, there is paucity of data from resource limited settings. We evaluated the epidemiology of MDR-CPE of clinical origin in South Western Uganda. METHODS: From September 2013 to June 2014, all Enterobacteriaceae isolated from diverse specimens obtained from @entity1 attending Mbarara Regional Referral Hospital, South-western Uganda, were screened for MDR in a laboratory-based cross sectional study. Isolates found to be MDR were screened for @entity2893 susceptibility/resistance phenotypically by Kirby Bauer disc diffusion method following CLSI guidelines and genetically using the multiplex real-time Polymerase Chain Reaction (RT-PCR). RESULTS: Of the 658 strains isolated, 183 (27.8%) were MDR and 68 (37.15%) of those MDR exhibited at least one form of @entity2893 resistance with 23 (12.57%) and 56 (30.60%) isolates expressing phenotypic and genetic resistance, respectively. Eleven MDR-CPE (6.01%) isolates exhibited both phenotypic and genotypic resistance to @entity2888 . Only bla @entity2277 and bla OXA-48 genes were detected among the genetically resistant isolates. CONCLUSION: The high prevalence of MDR-CPE calls for @entity146 control and prevention strategies, including reinforcement of hand hygiene, using contact precautions and early detection of CPE through use of targeted surveillance and molecular techniques in resource limited settings.
