# The magnitude of MDR carbapenemase-producing Enterobacteriaceae isolates and associated factors among hospitalized patients of Northeast Ethiopia

## TL;DR

This study found a high prevalence of carbapenemase-producing bacteria among hospitalized patients in Ethiopia, highlighting the need for better infection control and antimicrobial stewardship.

## Contribution

The study provides new insights into the prevalence and risk factors for CPE in a hospital setting in Northeast Ethiopia.

## Key findings

- 86% of isolates were multidrug-resistant, with E. coli and K. pneumoniae being the most common carbapenemase producers.
- Risk factors included chronic disease, eating raw vegetables, and poor hand hygiene.
- CPE and CRE prevalence was 5.7% and 8.1%, respectively.

## Abstract

Currently, carbapenemase-producing Enterobacteriaceae (CPE) are becoming a global public health threat. Infections caused by these bacteria limit treatment options and are associated with high morbidity and mortality. This study aimed to assess the prevalence of CPE and identify associated risk factors.

A hospital-based cross-sectional study was conducted from June to August 2023. Clinical samples were cultured, and species identification was performed using standard biochemical tests. Antimicrobial susceptibility testing was done, and a modified carbapenem inactivation method was employed to confirm carbapenemase production. Data were entered using Epi Data and analysed with SPSS.

From a total of 143 isolates, the most commonly identified species were Escherichia coli (62 isolates, 43.4%) and Klebsiella pneumoniae (39 isolates, 27.3%). The highest level of resistance was against ampicillin (138 isolates, 96.5%), whereas the lowest was observed with meropenem (19 isolates, 13.3%). Overall, 123 isolates (86.0%) were classified as MDR. The prevalence of CPE and carbapenem-resistant Enterobacteriaceae (CRE) was 5.7% and 8.1%, respectively. K. pneumoniae and E. coli were the most common carbapenemase producers. Chronic underlying disease, consuming raw vegetables, and lack of regular hand-washing habits before meals showed adjusted odds ratios of 7.9 (95% CI 1.9–31.5), 11 (95% CI 3.4–40) and 8.0 (95% CI 1.7–85), respectively, showing a significant association.

The high prevalence of CPE underscores the need for urgent infection control measures. Implementing antimicrobial stewardship, strengthening infection control measures, and further molecular studies are vital to combating this problem.