Carbapenemase producing Enterobacterieceae carriage among health care workers in selected units of Mulago national referral hospital and Uganda heart institiute
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Background:Antimicrobial resistance is a global public health concern contributing to increased morbidity and mortality particularly in low income countries where infection control is often inadequate. Multidrug-resistant (MDR) bacteria cause a significant proportion of hospital-associated infections and contribute to failure of management of the infections with adverse clinical outcomes. Healthcare Workers (HCWs) are at a high risk of acquiring, carrying and transmitting resistant organisms including carbapenemase-producing Enterobacteriaceae (CPE) not only to their household member but also in the hospital and community. The higher the proportion of fecal carriage of these resistant organisms, the higher the risk of transmission and infection. Resistance to carbapenemshas been reported in Uganda and yet they are last-line drugs, expensive and not always available in low income countries.The aim wasto describe the fecal carriage of CPE among HCWs from high dependence units of Mulago National Referral Hospital(MNRH) and Uganda Heart Institute(UHI) and determine the factor associated with carrying these serious threats. Methodology:Fecal samples were collected from 108 HCWs and cultured for CPE at the microbiology laboratory,Makerere University College of Health Sciences. Biochemical testes were used for bacteria identification. Kirby-Bauer disk diffusion were used to screen for antimicrobial susceptibility testing. Then, the phenotypic β-lactamase tests such as combined disks test, double disk synergy andModified Carbapenem Inactivation Method (mCIM) were performed to phenotypically screen for ESBL, AmpC β-lactamases and Carbapenemase producers. Results:Prevalence of carriage among the 108 participants was 35.2%(38/108)for CPE,62%ESBL and 4.6% AmpC; 78.7%isolates (188) were MDR. The highest carriage of CPE was obtained among midwife 33.3% followed by nurse 27.8% then cleaners 25%. Conclusion: There was a high prevalence of 35.2%.We recommend continuous surveillance in hospitals to detect the ES𝛽L-, AmpC and carbapenemase-producing strains and multidrug strains in hospitals for both patient and HCWs as well applying effective strategies for antimicrobial therapy and infection control measures to decrease the increasing burden of antibiotic resistance and to prevent their spread.