NDLI: Epidemiology, antimicrobial resistance profile, associated risk factors and management of carbapenem resistant Klebsiella pneumoniae in children under 5 with suspected sepsis in Ethiopia

Content Provider	Springer Nature : BioMed Central
Author	Gadisa, Eshetu Egyir, Beverly Fekede, Ebissa Adu, Bright Danso, Justice Oclu, Agnes Owusu-Nyantakyi, Christian Amuasi, Grebstad Rabbi Bortey, Alfred Disasa, Guta Tessema, Tesfaye Sisay
Abstract	Background Early detection and treatment of carbapenem-resistant Klebsiella pneumoniae (CRKP) could reduce the risk of developing life-threatening sepsis in childhood. However, little is known about sepsis caused by CRKP in children under-5 in developing countries. This study aimed to determine the epidemiology, antimicrobial resistance profile, associated risk factors and management of CRKP in children under-5 with sepsis in Ethiopia. Methods This prospective multicenter study was conducted from June 2021 to December 2023 in three tertiary hospitals in Ethiopia. Samples collection and processing, identification and antimicrobial susceptibility testing were performed according to CLSI guidelines. Sociodemographic data were collected using structured questionnaires. Data were analyzed using STATA-21 and logistic regression to determine associated risk factors. A p-value < 0.05 was considered statistically significant. Results Among 2483 children under-5 who were suspected of having sepsis, 530 (21.3%) were infected with K. pneumoniae. Infants and newborns were the most vulnerable age categories, with incidences of 25.3% and 34.2%, respectively. About 92.1% and 47.4% of the isolates were confirmed to produce ESBLs and -carbapenemases, respectively. Thus, isolates were resistant to cephalosporins(91–100%), gentamicin(83.7%), meropenem(49.1%), tigecycline(39%), and amikacin(21%). The prevalence rates of MDR, XDR, and PDR strains were 95.7%, 25.9%, and 11.4%, respectively. Combining amikacin with meropenem or tigecycline was used as a treatment option for XDR and PDR strains. . Regarding risk factors for sepsis caused by K. pneumoniae included prematurity [AOR = 7.1; 95%CI: 2.3–10.3], prolonged hospitalization [AOR = 4.4;95%CI = 1.9–8.2], admission to the ICU [AOR = 6.2;95% CI:2.8–9.2], pneumonia [AOR = 5.1;95%CI:1.6–13.2], meningitis [AOR = 15.3;95%CI:8.1–29.9], UTI [AOR = 2.1; 95%CI = 1.2–4.2], invasive procedures [AOR = 4.8; 95%CI:1.4–15.5], comorbidities [AOR = 4.2;95%CI = 2.2–13.2], parturition [AOR = 5.4;95%CI:2.5–13.3], and membrane rupture [AOR = 12.1; 95%CI = 2.3–26.2]. Conclusions The prevalence of bacterial sepsis caused by CRKP in children under 5 is high and became a serious public health concern that requires immediate attention and action.Therefore, it is crucial to revise treatment guidelines and improve IPC practices to reduce children’s morbidity and mortality from those superbugs and beyond.
Related Links	https://bmcinfectdis.biomedcentral.com/counter/pdf/10.1186/s12879-024-10366-4.pdf
Ending Page	13
Page Count	13
Starting Page	1
File Format	HTM / HTML
ISSN	14712334
DOI	10.1186/s12879-024-10366-4
Journal	BMC Infectious Diseases
Issue Number	1
Volume Number	24
Language	English
Publisher	BioMed Central
Publisher Date	2024-12-23
Access Restriction	Open
Subject Keyword	Infectious Diseases Parasitology Medical Microbiology Tropical Medicine Internal Medicine Carbapenem-resistant Klebsiella pneumoniae Antimicrobial resistance PDR Under-five children
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases
Journal Impact Factor	3.4/2023
5-Year Journal Impact Factor	3.3/2023

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