Fecal Carriage Of Extended-spectrum Beta-lactamase And Carbapenemase-producing Enterobacteriaceae Among Hospitalized Patients At Debre Berhan Comprehensive Specialized Hospital North Shoa Amhara Regional State Ethiopia.

Background: The rapid spread of extended-spectrum beta-lactamase (ESBL) and rncarbapenemase-producing Enterobacteriaceae (CPE) has become a major public health issue.rnGastrointestinal carriage of ESBL and CPE are the significant risk factors for infection andrndissemination of resistance clones in the hospital. Therefore, conducting research on the carriagernrate of ESBL and carbapenemase-producing Enterobacteriaceae is very important to preventrnnosocomial infection and the spread of antimicrobial-resistant bacteria in the hospital setting. rnObjective: To determine the fecal carriage of extended-spectrum beta-lactamase andrncarbapenemase-producing Enterobacteriaceae among hospitalized patients at Debre BerhanrnComprehensive Specialized Hospital, North Shoa, Amhara Regional State, Ethiopia. rnMethods: A hospital-based cross-sectional study was conducted among 383 hospitalized patientsrnfrom November 2020 to March 2021. Stool sample or rectal swab was aseptically collected andrncultured on MacConkey agar and Xylose lysine deoxycholate agar. The isolatedrnEnterobacteriaceae were further identified by conventional biochemical tests. Screening of ESBLrnproduction was done by using cefotaxime and ceftazidime. All Enterobacteriaceae were screenedrnfor carbapenemase production using meropenem and imipenem. Confirmation of ESBLrnproduction was done using the combination disk method. Carbapenemase production wasrnconfirmed by a rapid Carba NP test. Data was entered using Epi data version 3.1 then analyzedrnusing Statistical Package for Social Sciences software version 25. P-value ≤ 0.05 was consideredrnas statistically significant. rnResults: A total of 347 Enterobacteriaceae were isolated. The overall magnitude of ESBL-PErnand CPE was 47.3% (n=164/347) and 5.5% (n=19/347) respectively. The predominant extendedspectrumrnrnbeta-lactamase-producing Enterobacteriaceae (ESBL-PE) were E. coli 25.9%rn(n=90/347) and K. pneumoniae 15.9% (n=55/347). K. pneumoniae 3.5% (n= 12/347) was thernhighest carbapenemase producer. The overall multidrug resistance rate was 87.8% (n=305/347).rnThe highest resistance was observed to ampicillin (98.3%), followed by gentamicin (80.7%), andrntetracycline (73.3%) respectively. History of antibiotic use in the past 3 months (p≤0.000),rnadmission in a neonatal intensive care unit (p=0.023), and presence of chronic disease (p≤0.000)rnwere independently associated with fecal carriage of ESBL-PE. History of hospitalization in thernpast 12 months showed statistical significance with fecal carriage of CPE (p= 0.02). rnConclusion and Recommendation: The magnitude of ESBL-PE and CPE was high in the studyrnarea. Therefore, strict infection control measure is needed in the study area to limit the infectionrnand dissemination of these pathogens. Meropenem, imipenem, and chloramphenicol were activernagainst ESBL-PE.

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