The prevalence of Carbapenem Resistant Enterobacterales (CRE) in healthcare settings in Nigeria is a cause for concern, as it continues to amplify morbidity and mortality rates due to bacterial infections. Particularly in regions like sub-Saharan Africa where antibiotic selections are limited, this creates a precarious situation. In addition, patients in healthcare facilities showing CRE rectal colonization could potentially become invasive infection carriers.
This analysis is based on a descriptive, cross-sectional study carried out from December 2021 to September 2022 in Ibadan, Nigeria. Patients attending primary, secondary and tertiary healthcare facilities were screened to assess the prevalence of rectal CRE carriage and the organisms’ antibiotic susceptibility patterns. Out of the patients screened, approximately 17.5% were found to have CRE colonization. Remarkably, 84.3% of CRE isolates found were resistant to at least three distinct classes of antibiotics.
This finding underscores the urgency for implementing robust infection prevention and control practices (IPC) and surveillance in healthcare facilities. The result also indicates the pressing need for regulations on the usage of antibiotics, particularly in underprivileged countries. For such locales, Enterobacterales, such as Escherichia coli and Klebsiella pneumoniae, often become leading pathogens causing death tied to antimicrobial resistance (AMR). Therefore, monitoring CRE colonization is essential as it could provide predictive data for the potential burden and risk of invasive CRE disease in the patient population.
The study raises awareness about the insufficient data concerning CRE rectal colonization in healthcare settings in Nigeria. While there are policies for CRE infection control outlined in Nigeria, predominantly related to hand hygiene and controlling broad spectrum antibiotic use, their implementation remains inconsistent due to resource constraints. As a priority, these findings implore the need for systematic CRE carriage screening to thwart CRE infections. This study’s contributions significantly fill data gaps related to CRE rectal colonization in Nigeria, offering valuable insights potentially beneficial on a global scale.
Source: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09627-z