Colonization and Acquisition of Carbapenem-Resistant and Carbapenemase-Producing <i>Enterobacterales</i> Among Hospitalized Adult Patients in Addis Ababa, Ethiopia

Abstract

Carbapenem-resistant Enterobacterales (CRE), particularly carbapenemase-producing CRE (CP-CRE) are a growing global threat in health care. Intestinal colonization increases infection risk and facilitates transmission in the hospital. We aimed to determine intestinal colonization of CRE and CP-CRE among hospitalized patients in Addis Ababa, Ethiopia. A longitudinal study was conducted on 165 patients from February 2023 to April 2024 at Tikur Anbessa Specialized Hospital. Microbial identification and antimicrobial susceptibility testing were done using VITEK 2. Carbapenemase production was confirmed using the modified carbapenem inactivation method, and Polymerase Chain Reaction (PCR) was used to detect carbapemase genes. CRE colonization was detected in 19.4% of patients at admission and 18.8% during follow-up, showing no significant change ( p = 0.65). CP-CRE colonization was increased from 10.3% at admission to 16.4% ( p = 0.03) during follow-up. The most frequently identified genes were bla NDM (71.0%) and bla OXA-48 (53.0%) at admission. These genes were detected in (74.1%) and (48.1%) during follow-up, respectively. A substantial burden of CRE and CP-CRE colonization was found, with a high persistence rate. Screening high-risk patients and strengthening infection prevention measures are urgently needed.