ArticleAnnals of clinical microbiology and antimicrobials2023
Multidrug-resistant Gram-negative bacterial infections and associated factors in a Kenyan intensive care unit: a cross-sectional study.
Article in Annals of clinical microbiology and antimicrobials, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Prevalence of colistin-resistant Enterobacteriaceae isolated from clinical samples in Africa: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Prevalence of colistin resistance in clinical isolates ofFrontiers in microbiology · 2024Pooled it
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- Role of diagnostic testing in reducing unnecessary antibiotic use for upper respiratory tract infections in Chinese primary healthcare: a mixed-methods study.BMC primary care · 2026Article
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- Colistin-resistance amongJAC-antimicrobial resistance · 2026Review
- From Lake Victoria to the Tap: Antibiotic Resistance and Pathogenic Contamination of Kisumu City Water Supply and Wastewater Network.Tropical medicine & international health : TM & IH · 2026Article
- Epidemiology of Urinary Pathogens and Antibiotic Resistance Trends: A Retrospective Analysis Stratified by Age and Sex from a Large Tertiary Hospital in Saudi Arabia.Infection and drug resistance · 2026Article
- Prevalence and antimicrobial susceptibility of multi drug-resistant bacteria isolates in adult intensive care units: a six-year retrospective study from a tertiary hospital in Mogadishu, Somalia.BMC infectious diseases · 2025Article
- Extended-spectrum β-lactamase and carbapenemase-producing bacteria urinary tract infections in adult HIV-positive outpatients at Embu County Referral Hospital, Kenya.BMC microbiology · 2025Article
- Antimicrobial susceptibility pattern of extended-spectrum β-lactamase producing gram-negative bacteria isolated from clinical samples: A cross-sectional hospital-based study.Journal of family medicine and primary care · 2025Article
- Asymptomatic faecal carriage of vancomycin-resistant Enterococci among inpatients and outpatients in a Kenyan hospital: a cross-sectional study.Antimicrobial resistance and infection control · 2025Article
- Epidemiology, resistance profiles, and risk factors of multidrug- and carbapenem-resistant Serratia marcescens infections: a retrospective study of 242 cases.BMC infectious diseases · 2025Article
- Article
- Prevalence of colistin resistance in multidrug-resistantJAC-antimicrobial resistance · 2025Review
- Bacteriological profile and antimicrobial resistance in sepsis cases in intensive care units in Lubumbashi: challenges and perspectives.Annals of clinical microbiology and antimicrobials · 2025Article
- Evaluation of Infections Caused by Carbapenem-ResistantAntibiotics (Basel, Switzerland) · 2025Article
- Predicting infections with multidrug-resistant organisms (MDROs) in neurocritical care patients with hospital-acquired pneumonia (HAP): development of a novel multivariate prediction model.Microbiology spectrum · 2025Article
- Multidrug-resistant bacterial infections and their clinical impact at the University Teaching Hospital of Kigali in Rwanda: a retrospective descriptive-analytical study.Frontiers in public health · 2025Article
- Investigating Gram-negative bacilli isolates' sensitivity to ceftazidime/avibactam.Journal of family medicine and primary care · 2025Article
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients admitted to intensive care units (ICU) are at risk of Gram-negative bacteria (GNB) infections, especially those caused by multidrug-resistant (MDR) isolates, increasing morbidity, mortality, and healthcare costs. However, epidemiological surveillance data on MDR bacteria to inform infection prevention and control (IPCs) interventions is limited in our study setting. Here we assessed the prevalence and factors associated with GNB infections in ICU- patients admitted in our study setting.
methodsThis was a hospital-based cross-sectional study among patients admitted to ICU at the Nairobi West Hospital, Kenya, between January and October 2022. Altogether, we recruited 162 patients, excluding those hospitalized for less than 48 h and declining consent, and collected demographics and clinical data by case report form. Blood, wound and throat swab, ascetic tap, stool, urine, tracheal aspirate, and sputum samples were collected cultured. Isolates identity and antimicrobial susceptibility were elucidated using the BD Phoenix system.
resultsThe prevalence of GNB infections was 55.6%, predominated by urinary tract infections (UTIs). We recovered 13 GNB types, with Escherichia coli (33.3%) and Klebsiella pneumoniae (31.1%) as the most common isolates. Factors associated with GNB infections were a history of antibiotic use (aOR = 4.23, p = 0.001), nasogastric tube use (NGT, aOR = 3.04, p = 0.013), respiratory tract (RT, aOR = 5.3, p = 0.005) and cardiovascular (CV, aOR = 5.7, p = 0.024) conditions. 92% of the isolates were MDR,predominantly Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa.
conclusionWe report a high prevalence of MDR-GNB infections, predominated by UTI, in ICU, whereby patients with a history of antibiotic use, using the NGT, and having RT and CV conditions were at increased risk. To improve the management of ICU-admitted patients, continuous education, training, monitoring, evaluation and feedback on infection prevention and control are warranted in our study setting.
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