- Title
- Molecular analysis of Tigecycline Resistance in Carbapenem-Resistant Enterobacterales (CRE) in Mthatha and surrounding hospitals
- Creator
- Vumba, Luyolo
- Description
- The emergency of carbapenem-resistant Enterobacterales is prevalent and poses a significant threat to health systems worldwide. The European Center for Disease Control and Prevention has reported a mortality rate of about 50% in patients with CRE bloodstream infections. This study aimed to conduct a molecular analysis of tigecycline resistance in 100 CRE in clinical isolates from Mthatha and surrounding hospitals. The results showed a notable high prevalence of CRE infections in neonatal, male surgical, and maternal and pediatric wards, predominantly driven by Klebsiella spp. (53.4%), followed by Enterobacter spp. (20.5 %), then Escherichia coli (6.7%). The present study performed tigecycline AST using an E-test on 100 CRE hospital isolates., A total of 92.8 % CRE was susceptible to tigecycline, 1.6 % intermediate resistant to tigecycline, and 5.8 % resistant to tigecycline. A multiplex SYBR green-based PCR assay for rapid detection of tet(X) and its variants, including tet(X1), tet(X2), and high-level tigecycline resistance genes tet(X3), tet(X4), and tet(X5) were developed. The results in 100 CRE clinical isolates studied indicated that there were no tet (X) gene detected that was responsible for tigecycline resistance. The risk factors associated with tigecycline resistance in CRE include age, pre-exposure to antibiotics, prolonged hospitalization, and undergoing invasive procedures indicated by strong r2 =0.9501. CRE gradually evolves, posing a significant threat to patients of all ages. Early detection of carbapenemase production in clinical infections, carriage states, or both is essential to prevent hospital based outbreaks. As using Tigecycline is the last line of treatment for CRE infection, the high rate of tigecycline resistance in this study is alarming for the healthcare system in South Africa. Tigecycline combination therapy is recommended when treating critically ill patients. Tet (X) genes are not responsible for tigecycline resistance in the sample of this study. The risk factors associated with tigecycline resistance in CRE include age, pre exposure to antibiotics, prolonged hospitalization, and undergoing invasive procedures.
- Description
- Degree: M. Science (Medical Microbiology)
- Date
- 2024
- Subject
- Tigecycline resistance
- Subject
- E-test CRE infections
- Subject
- Risk factors associated with tigecycline resistance
- Subject
- Tet(X) genes
- Subject
- PCR
- Type
- Masters (Thesis)
- Identifier
- http://hdl.handle.net/11260/13529
- Identifier
- vital:78944
- Language
- English
- Rights
- Walter Sisulu University
- Hits: 6
- Visitors: 4
- Downloads: 3
| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details | SOURCE1 | Vumba, L.B. Masters Thesis.pdf | 1 MB | Adobe Acrobat PDF | View Details |