Table 1.
Distribution of Various Extended-spectrum β-Lactamase Gram-negative Bloodstream Isolates and Countries of Origin
| Bacteria Isolated, N | Burkina Faso | Ethiopia | Ghana | Guinea-Bissau | Kenyaa | Madagascar | Senegal | Sudan | Tanzania | Total Isolates (%)b |
|---|---|---|---|---|---|---|---|---|---|---|
| Enterobacteriaceae | ||||||||||
| Enterobacter spp. | 0 | 0 | 5c | 2 | 0 | 16 | 4 | 0 | 0 | 27 (5.3) |
| ESBL Phenotype pos.d | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 1 (3.7) |
| ESBL Genotype pos.e | 0 | 0 | 2 | 0 | 0 | 0 | 2 | 0 | 0 | 4 (14.8) |
| Escherichia coli | 7 | 1 | 85c | 0 | 0 | 3 | 15 | 5 | 6 | 122 (24.2) |
| ESBL Phenotype pos. | 2 | 0 | 5 | 0 | 0 | 0 | 0 | 0 | 0 | 7 (5.7) |
| ESBL Genotype pos. | 1 | 0 | 4 | 0 | 0 | 0 | 0 | 0 | 0 | 5 (4.1) |
| Klebsiella spp. | 0 | 0 | 77c | 0 | 0 | 8 | 1 | 0 | 2 | 88 (17.4) |
| ESBL Phenotype pos. | 0 | 0 | 39 | 0 | 0 | 1 | 0 | 0 | 0 | 40 (45.5) |
| ESBL Genotype pos. | 0 | 0 | 34 | 0 | 0 | 2 | 0 | 0 | 0 | 36 (40.9) |
| iNTS | 12 | 0 | 118c | 11 | 1 | 5 | 8 | 0 | 4 | 159 (31.5) |
| ESBL Phenotype pos. | 0 | 0 | 2 | 0 | 0 | 0 | 0 | 0 | 0 | 2 (1.3) |
| ESBL Genotype pos. | 0 | 0 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 2 (1.3) |
| Serratia spp. | 0 | 0 | 12 | 0 | 0 | 0 | 0 | 0 | 0 | 12 (2.4) |
| ESBL Phenotype pos. | 0 | 0 | 2 | 0 | 0 | 0 | 0 | 0 | 0 | 2 (16.7) |
| ESBL Genotype pos. | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Proteus mirabilis | 3 | 0 | 3c | 0 | 0 | 0 | 3 | 5 | 1 | 15 (3.0) |
| ESBL Phenotype pos. | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 2 (13.3) |
| ESBL Genotype pos. | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Non-Enterobacteriaceae | ||||||||||
| Acinetobacter spp. | 2 | 0 | 22 | 7 | 0 | 3 | 0 | 3 | 0 | 37 (7.3) |
| ESBL Phenotype pos. | 0 | 0 | 4 | 0 | 0 | 2 | 0 | 0 | 0 | 6 (16.2) |
| ESBL Genotype pos. | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Burkholderia spp. | 0 | 1 | 0 | 2 | 0 | 0 | 2 | 0 | 0 | 5 (1.0) |
| ESBL Phenotype pos. | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| ESBL Genotype pos. | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Pseudomonas spp. | 3 | 0 | 26 | 0 | 0 | 0 | 0 | 0 | 0 | 29 (5.7) |
| ESBL Phenotype pos. | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| ESBL Genotype pos. | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Otherf | 0 | 0 | 6 | 0 | 0 | 4 | 0 | 1 | 0 | 11 (2.2) |
| ESBL Phenotype pos. | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 1 (9.1) |
| ESBL Genotype pos. | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Total isolates from each country (%) | 27 (5.3) | 2 (0.4) | 354 (70.1) | 22 (4.4) | 1 (0.2) | 39 (7.7) | 33 (6.5) | 14 (2.8) | 13 (2.6) | 505 (100.0) |
| ESBL Phenotype pos. total by country (%) | 3 (6.0) | 0 (0) | 53 (86.9) | 0 (0) | 0 (0) | 4 (6.6) | 0 (0) | 0 (0) | 1 (2.0) | 61 (100.0) |
| ESBL Genotype pos. total by country (%) | 1 (2.1) | 0 (0) | 41 (87.2) | 0 (0) | 1 (2.1) | 2 (4.3) | 2 (4.3) | 0 (0) | 0 (0) | 47 (100.0) |
Abbreviation: ESBL, extended spectrum β-lactamase; iNTS, invasive non-typhoidal Salmonella spp.
aDue to logistic constraints, ONLY Salmonella spp. from the Kenya site could be analyzed.
bProportions for ESBL phenotype- and genotype-positives expressed as percentages of each specific species total.
cIncludes data that was published previously by Eibach et al [20].
dESBL phenotype-positive refers to resistance to ceftriaxone and susceptibility β-lactamase inhibitor (amoxicillin-clavulanate) OR resistance to ceftazidime and susceptibility to β-lactamase inhibitor (amoxicillin-clavunalate)
eESBL genotype-positive refers to pathogens expressing CTX-M genes detected by polymerase chain reaction.
fOther non-Enterobacteriaceae includes Achromobacter spp., Wautersiella spp., Stenotrophomonas spp., Pasteurella spp., Comamonas spp.