{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:07:44Z","timestamp":1772168864628,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.133298.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:00:00Z","timestamp":1733788800000}}],"reference-count":34,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:00:00Z","timestamp":1733788800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Not funded","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>\n                    Background Bacterial infections in the Intensive Care Units are a threat to the lives of critically ill patients. Their vulnerable immunity predisposes them to developing bacteria-associated sepsis, deteriorating their already fragile health. In the face of increasing antibiotics resistance, the problem of bacterial infection in ICU is worsening. Surveillance of bacterial infections in ICUs and drug resistance will help to understand the magnitude of the problem it poses and inform response strategies. We assessed bacterial infections in ICU setting by identifying prevalent Gram-negative bacterial species and characterized their antibiotic susceptibility patterns. Methods Cross-sectional samples collected from Kenyatta National Hospital ICU between January and June 2021 were cultured and phenotypic identification of culture-positive samples performed using VITEK 2. Antibiotic susceptibility patterns were determined based on Antimicrobial Susceptibility Testing (AST) results. Cephalosporin-resistant Gram-negative bacteria were assessed by PCR to detect the presence of ESBL genes including (\n                    <ns4:italic>\n                      <ns4:sup>bla<\/ns4:sup>\n                    <\/ns4:italic>\n                    CTX-M,\n                    <ns4:italic>\n                      <ns4:sup>bla<\/ns4:sup>\n                    <\/ns4:italic>\n                    SHV,\n                    <ns4:italic>\n                      <ns4:sup>bla<\/ns4:sup>\n                    <\/ns4:italic>\n                    TEM,\n                    <ns4:italic>\n                      <ns4:sup>bla<\/ns4:sup>\n                    <\/ns4:italic>\n                    OXA) Results and discussion Out of the 168 Gram-negative isolates,\n                    <ns4:italic>Acinetobacter baumanii<\/ns4:italic>\n                    was the most abundant (35%). Other isolates that were present at frequencies more than 15% are\n                    <ns4:italic>Klebsiella pneumoniae<\/ns4:italic>\n                    and\n                    <ns4:italic>Escherichia. coli. A. baumaniii<\/ns4:italic>\n                    is known to be a notorious bacterium in ICU due to its multidrug resistance nature. Indeed,\n                    <ns4:italic>A. baumanii<\/ns4:italic>\n                    isolates from Kenyatta National Hospital showed significantly high level of phenotypic resistance. Concordant with the high level of phenotypic resistance, we found high carriage of the ESBL genes among the isolates analysed in this study. Moreover, majority of isolates harboured all the four ESBL genes. Conclusion A high rate of phenotypic and genetic resistance was detected among the tested isolates. Resistance to cephalosporins was primarily driven by acquisition of the ESBL genes. The high prevalence rate of ESBL genes in ICU bacterial isolates shown in this study has a important implication for ICU patient management and general antibiotics use.\n                  <\/ns4:p>","DOI":"10.12688\/f1000research.133298.2","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T11:19:29Z","timestamp":1733829569000},"page":"469","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Phenotypic and genetic extended spectrum beta lactamase profiles of bacterial isolates from ICU in tertiary level hospital in Kenya"],"prefix":"10.12688","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4429-201X","authenticated-orcid":false,"given":"Job","family":"Mwale","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7735-1576","authenticated-orcid":false,"given":"Edwin O.","family":"Magomere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4992-6838","authenticated-orcid":false,"given":"Brian","family":"Maina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leon","family":"Otieno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1195-8762","authenticated-orcid":false,"given":"Frank G.","family":"Onyambu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Kassim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy","family":"Muchiri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2024,12,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1-7","DOI":"10.1186\/2110-5820-1-47","article-title":"The rising problem of antimicrobial resistance in the intensive care unit.","volume":"1","author":"N Brusselaers","year":"2011","journal-title":"Ann. Intensive Care."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"482","DOI":"10.3389\/fphar.2019.00482","article-title":"Risk factors of ventilator-associated pneumonia in critically III patients.","volume":"10","author":"D Wu","year":"2019","journal-title":"Front. Pharmacol."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"475-481","DOI":"10.1016\/S2213-2600(20)30079-5","article-title":"Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study.","volume":"8","author":"X Yang","year":"2020","journal-title":"Lancet Respir. Med."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"695-699","DOI":"10.1016\/j.jiph.2019.03.014","article-title":"Antimicrobial consumption and bacterial resistance pattern in patients admitted in ICU at a tertiary care center.","volume":"12","author":"S Saxena","year":"2019","journal-title":"J. Infect. Public Health."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s13756-020-00871-x","article-title":"Infections and antimicrobial resistance in intensive care units in lower-middle income countries: a scoping review.","volume":"10","author":"Y Saharman","year":"2021","journal-title":"Antimicrob. Resist. Infect. Control."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1314","DOI":"10.3390\/microorganisms10071314","article-title":"Bloodstream infections in a COVID-19 Non-ICU department: Microbial epidemiology, resistance profiles and comparative analysis of risk factors and patients\u2019 outcome.","volume":"10","author":"E Giannitsioti","year":"2022","journal-title":"Microorganisms."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1186\/s12879-017-2529-z","article-title":"Patterns of antimicrobial resistance in intensive care unit patients: a study in Vietnam.","volume":"17","author":"G Tran","year":"2017","journal-title":"BMC Infect. Dis."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"482-501","DOI":"10.3934\/microbiol.2018.3.482","article-title":"An overview of the antimicrobial resistance mechanisms of bacteria.","volume":"4","author":"W Reygaert","year":"2018","journal-title":"AIMS microbiology."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1076-1084","DOI":"10.1590\/S1517-83822011000300028","article-title":"Extended-spectrum beta-lactamase-producing bacteria isolated from hematologic patients in Manaus, State of Amazonas, Brazil.","volume":"42","author":"C Ferreira","year":"2011","journal-title":"Braz. J. Microbiol."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"433-441","DOI":"10.1097\/MCC.0000000000000755","article-title":"Antimicrobial resistance in ICUs: an update in the light of the COVID-19 pandemic.","volume":"26","author":"R Cant\u00f3n","year":"2020","journal-title":"Curr. Opin. Crit. 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J."},{"key":"ref14","article-title":"Third generation cephalosporins.","author":"V Arumugham","year":"2019"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1186\/s13756-023-01263-7","article-title":"Carriage of ESBL-producing Klebsiella pneumoniae and Escherichia coli among children in rural Ghana: a cross-sectional study.","volume":"12","author":"C Akenten","year":"2023","journal-title":"Antimicrob. Resist. Infect. Control."},{"key":"ref16","article-title":"Determining sample size.","author":"G Israel","year":"1992"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"111-155","DOI":"10.1186\/1471-2180-12-155","article-title":"Analysis of \u03b2-lactamase phenotypes and carriage of selected \u03b2-lactamase genes among Escherichia coli strains obtained from Kenyan patients during an 18-year period.","volume":"12","author":"J Kiiru","year":"2012","journal-title":"BMC Microbiol."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"853-862","DOI":"10.4236\/aim.2019.910052","article-title":"Prevalence of CTXM, SHV, TEM AND OXA Genes among Extended-Spectrum Beta-Lactamase Producing Klebsiella pneumoniae from Mukuru Slum, Kenya.","volume":"09","author":"H Saisi","year":"2019","journal-title":"Adv. Microbiol."},{"key":"ref19","article-title":"Hospital acquired infections in a private paediatric hospital in Kenya: a retrospective cross-sectional study.","volume":"41","author":"R Patil","year":"2022","journal-title":"Pan Afr. Med. J."},{"key":"ref20","article-title":"Regional strategy on prevention and containment of antimicrobial resistance, 2010.","year":"2010"},{"key":"ref21","first-page":"222-225","article-title":"Bacterilogical profile and drug resistance pattern of isolates of the patients admitted in medical intensive care unit of a tertiary care hospital in Ahmedabad.","volume":"4","author":"T Mehta","year":"2015","journal-title":"Med. Sci."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"400","DOI":"10.3390\/antibiotics13050400","article-title":"Prevalence of Infections and Antimicrobial Resistance of ESKAPE Group Bacteria Isolated from Patients Admitted to the Intensive Care Unit of a County Emergency Hospital in Romania.","volume":"13","author":"A Bereanu","year":"2024","journal-title":"Antibiotics."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"66-69","DOI":"10.3329\/imcj.v4i2.6499","article-title":"Bacterial profile and their antimicrobial resistance pattern in an intensive care unit of a tertiary care hospital of Dhaka.","volume":"4","author":"L Barai","year":"2010","journal-title":"Ibrahim Med. Coll. J."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"376-381","DOI":"10.1513\/AnnalsATS.201506-368BC","article-title":"Use of Tracheal Aspirate Culture in Newly Intubated Patients with Community-Onset Pneumonia.","volume":"13","author":"L McCauley","year":"2016","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"3597-3604","DOI":"10.1128\/JCM.01494-14","article-title":"Endotracheal aspirate and bronchoalveolar lavage fluid analysis: interchangeable diagnostic modalities in suspected ventilator-associated pneumonia?.","volume":"52","author":"J Scholte","year":"2014","journal-title":"J. Clin. Microbiol."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"8080","DOI":"10.3390\/ijms22158080","article-title":"Coming from the wild: multidrug resistant opportunistic pathogens presenting a primary, not human-linked, environmental habitat.","volume":"22","author":"F Sanz-Garc\u00eda","year":"2021","journal-title":"Int. J. Mol. Sci."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1-8","DOI":"10.1186\/1471-2334-6-130","article-title":"How long do nosocomial pathogens persist on inanimate surfaces? A systematic review.","volume":"6","author":"A Kramer","year":"2006","journal-title":"BMC Infect. Dis."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"148","DOI":"10.3389\/fmicb.2012.00148","article-title":"The Acinetobacter baumannii oxymoron: commensal hospital dweller turned pan-drug-resistant menace.","volume":"3","author":"I Roca","year":"2012","journal-title":"Front. Microbiol."},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0286955","article-title":"Source-tracking ESBL-producing bacteria at the maternity ward of Mulago hospital, Uganda.","volume":"18","author":"R Mayanja","year":"2023","journal-title":"PLoS One."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"107-114","DOI":"10.1016\/j.jgar.2022.05.023","article-title":"Gastrointestinal colonization of extended-spectrum beta-lactamase-producing bacteria among children below five years of age hospitalized with fever in Dar es Salaam, Tanzania.","volume":"30","author":"U Kibwana","year":"2022","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"835","DOI":"10.3390\/antibiotics11070835","article-title":"Molecular characterization of carbapenem-resistant Acinetobacter baumannii isolated from intensive care unit patients in Jordanian hospitals.","volume":"11","author":"S Al-Sheboul","year":"2022","journal-title":"Antibiotics."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1-6","DOI":"10.2174\/1874285802115010001","article-title":"Characteristic of Extended Spectrum \u03b2-Lactamase-Producing Enterobacteriaceae from Fecal Carriage Isolates of Intensive Care Unit Patients at Sanglah Hospital, Bali, Indonesia.","volume":"15","author":"I Candra","year":"2021","journal-title":"Open Microbiol. 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