Table 1.
Studies reporting carbapenemase-producing Enterobacteriaceae in Africa
| Country | Year of sampling | Type of study | Isolate source | Organisms | Number of isolates positive/total tested (%) | Carbapenemase described (number of isolates) |
Setting | Age group | Reference | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KPC | OXA | VIM | NDM | Others | |||||||||
| Algeria | 2008 | case report | urinary samples |
E. coli K. pneumoniae P. stuartii |
5/5 (100) | VIM-19 (2) VIM-19 (2) VIM-19 (1) |
H | NA | 48 | ||||
| Algeria | 2011 | case report | blood cultures | K. pneumoniae | NA | OXA-48 (1) | H | Ch | 135 | ||||
| Cameroona | NA | case report | rectal swab | E. coli | NA | NDM-4 (1) | H | NA | 103 | ||||
| Egypt | 2009–10 | laboratory-based surveillance | stool, blood, pus, urine, throat swab, peritoneal fluid |
K. pneumoniae E. coli E. cloacae |
10/10 (100) | OXA-48 (1) OXA-48 (2) — |
VIM-1 (2) VIM-1 (2) VIM-1 (4) |
H | Ch & A | 46 | |||
| Egypt | 2009–10 | case report | blood culture, sputum | K. pneumoniae | NA | OXA-163 (2) | H | A | 64 | ||||
| Egypt | 2010–11 | laboratory-based surveillance | NA | E. cloacae | 2/3 (67) | VIM-4 (2) | H | NA | 44 | ||||
| Egypt | 2011 | prospective study | urine, blood, respiratory tract specimens | K. pneumoniae | 14/45 (31.1) | KPC (14) | H | NA | 33 | ||||
| Egypt | 2009–10 | retrospective study | faecal, exudates, blood | E. coli | 3/73 (4.1) | OXA-48 (2) | VIM-1 (1) VIM-29 (1) |
H | Ch & A | 28 | |||
| Egypt | 2012 | case report | gastric fluid, blood | K. pneumoniae | NA | OXA-163 (1) | NDM-1 (1) | H | A | 57 | |||
| Kenya | 2007–09 | laboratory-based surveillance | urine, urethral pus | K. pneumoniae | 7/7 (100) | NDM-1 (7) | H | A | 58 | ||||
| Libyaa | 2011 | cross-sectional | nostrils, tonsils and perineum specimens | K. pneumoniae | NA | OXA-48 (7) | H | NA | 93 | ||||
| Libyaa | 2011 | case report | blood | K. pneumoniae | NA | OXA-48 (1) | H | A | 98 | ||||
| Libyaa | 2011 | cross-sectional | rectal swabs | K. pneumoniae | NA | OXA-48 (1) | H | NA | 99 | ||||
| Libyaa | 2011 | case series | CSF, pleural fluid, catheter, urine, endotracheal | K. pneumoniae | 6/6 (100) | OXA-48 (6) | H | NA | 105 | ||||
| Libyaa | 2011 | laboratory-based surveillance | NA | K. pneumoniae | NA | OXA-48 (13) | H | A | 136 | ||||
| Morocco | 2009–11 | laboratory-based surveillance | blood, urine, bone, skin abscess, urinary tract catheter |
K. pneumoniae K. oxytoca E. cloacae |
21/21 (100) | OXA-48 (16) OXA-48 (1) OXA-48 (4) |
H | Ch & A | 95 | ||||
| Morocco | 2009–11 | laboratory-based surveillance | NA |
K. pneumoniae E. cloacae E. coli M. morganii |
9/17 (53) | OXA-48 (2) OXA-48 (1) OXA-48 (2) OXA-48 (1) |
IMP-1 (1) IMP-1 (2) |
C | NA | 25 | |||
| Morocco | 2010–11 | laboratory-based surveillance | NA | E. coli | 2/47 (4) | OXA-48 (1) | IMP-1 (1) | C | Ch & A | 26 | |||
| Morocco | NA | case series | urine, blood, pancreatic abscess | K. pneumoniae | NA | NDM-1 (3) | H | A | 59 | ||||
| Morocco | NA | cross-sectional | water (puddles) | S. marcescens | NA | OXA-48 (2) | C | NA | 10 | ||||
| Morocco | 2012 | cross-sectional | rectal swabs |
K. pneumoniae E. cloacae |
10/37 (27) | OXA-48 (7) OXA-48 (3) |
H | NA | 32 | ||||
| Morocco | 2011 | cross-sectional | rectal swabs |
K. pneumoniae K. oxytoca K. terrigena E. cloacae E. coli |
24/28 (86) | OXA-48 (14) OXA-48 (1) OXA-48 (1) OXA-48 (2) OXA-48 (1) |
NDM-1 (5) | H | NA | 63 | |||
| Morocco | NA | case report | urine | K. pneumoniae | NA | OXA-48 (1) | VIM-1 (1) | NDM-1 (1) | C | A | 24 | ||
| Morocco | 2009–10 | prospective | blood, pus, urine, catheter, subcutaneous fluid collection |
K. pneumoniae K. oxytoca E. cloacae |
13/463 (2.8) | OXA-48 (6) OXA-48 (1) OXA-48 (3) |
NDM-1 (3) | H | NA | 36 | |||
| Morocco | 2009 | case report | NA | K. pneumoniae | NA | OXA-48 (1) | H | A | 69 | ||||
| Moroccoa | 2010 | case report | urine, rectal swab | E. cloacae | NA | OXA-48 (2) | H | NA | 71 | ||||
| Moroccoa | 2010 | case report | rectal swabs | K. pneumoniae | NA | OXA-48 (2) | H | NA | 137 | ||||
| Moroccoa | 2010 | case report | urine | E. coli | NA | OXA-48 (1) | H | A | 138 | ||||
| South Africa | 2011 | case report | urine, blood, tracheal aspirate, central venous catheter |
K. pneumoniae E. cloacae |
NA | KPC-2 (3) KPC-2 (1) |
NDM-1 (1) — | H | A | 41 | |||
| South Africa | 2011–12 | case series | tissue, urine, tracheal aspirate |
K. pneumoniae — S. marcescens |
NA | OXA-48 (3) OXA-181 (6) OXA-48 (1) |
H | Ch & A | 65 | ||||
| South Africa | NA | case report | sputum | E. cloacae | NA | NDM-1 (1) | H | A | 60 | ||||
| South Africa | 2010 | case report | pus | K. pneumoniae | NA | VIM-1 (1) | H | A | 47 | ||||
| South Africaa | 2012 | case report | urine | E. cloacae | NA | NDM-1 (1) | H | A | 61 | ||||
| Sierra Leone | 2010–11 | laboratory-based surveillance | NA |
E. cloacae E. coli K. pneumoniae Enterobacter spp. Providencia Enterobacteriaceae |
13/20 (65) | OXA-58 (4) OXA-58 (1) OXA-58 (3) OXA-58 (1) OXA-58 (1) |
VIM (3) VIM (1) VIM (4) — VIM (1) VIM (1) |
DIM-1 (3) DIM-1 (1) |
H | NA | 43 | ||
| Senegal | 2008–09 | case series | N/A |
K. pneumoniae E. coli E. cloacae Enterobacter sakazaki |
11/11 (100) | OXA-48 (8) OXA-48 (1) OXA-48 (1) OXA-48 (1) |
H | NA | 70 | ||||
| Tanzania | 2007–12 | laboratory-based surveillance | pus, urine, blood, aspirate, sputum |
K. pneumoniae E. coli K. oxytoca C. freundii M. morganii S. marcescens Salmonella spp. |
NA | KPC (3) KPC (4) |
OXA-48 (4) OXA-48 (3) OXA-48 (1) OXA-48 (1) |
VIM (11) VIM (4) — VIM (1) — VIM (2) VIM (1) |
NDM (2) NDM (2) NDM (1) — NDM (1) |
IMP (9) IMP (19) IMP (3) IMP (2) — — IMP (1) |
H | NA | 42 |
| Tunisia | 2010 | case report | urine | K. pneumoniae | NA | OXA-48 (2) | H | NA | 96 | ||||
| Tunisia | 2009–10 | laboratory-based surveillance | NA | K. pneumoniae | 21/153 (14) | OXA-48 (21) | H | NA | 139 | ||||
| Tunisia | 2005 | laboratory-based surveillanceb | urine, blood, wound, catheter, cerebral abscess, sputum | K. pneumoniae | 11/11 (100) | VIM-4 (11) | H | A | 45 | ||||
| Tunisia | 2009 | case report | sputum or blood | K. pneumoniae | NA | OXA-48 (1) | H | A | 140 | ||||
| Tunisia | 2011 | laboratory-based surveillanceb | rectal, nose, axilla, environmental swabs | P. stuartii | 13/13 (100) | OXA-48 (13) | H | A | 22 | ||||
| Tunisia | 2010 | cross-sectional | environmental swabs |
E. coli K. pneumoniae |
13/46 (28) | VIM-2 (4) — | IMP-1 (9) | H | NA | 20 | |||
| Tunisia | 2012 | case report | sternal pus | K. pneumoniae | NA | NDM-1 (1) | H | A | 62 | ||||
| Tunisia | 2009–11 | laboratory-based surveillance | pus, urine, blood |
K. pneumoniae C. freundii |
NA | OXA-48 (4) OXA-48 (1) |
H | Ch & A | 94 | ||||
NA, not available; H, hospital; C, community; Ch, children; A, adult.
For the ‘Carbapenemase described’ columns, blanks mean ‘not detected’.
aTransferred or travel patient.
bIdentified outbreak.