Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 21:4:1556842.
doi: 10.3389/frabi.2025.1556842. eCollection 2025.

The burden, risk factors, and antimicrobial susceptibility pattern associated with extended-spectrum beta-lactamase-producing E. coli and K. pneumoniae carriage among neonates and their surroundings at a referral hospital in the Moshi municipality

Happyness J Mshana  1 , Dorottya Kovacs  2 , Florida Muro  1   3   4 , Ruth Zadoks  2   5 , Katarina Oravcova  2 , Louise Matthews  2 , Blandina T Mmbaga  1   3   4
Affiliations

The burden, risk factors, and antimicrobial susceptibility pattern associated with extended-spectrum beta-lactamase-producing E. coli and K. pneumoniae carriage among neonates and their surroundings at a referral hospital in the Moshi municipality

Happyness J Mshana et al. Front Antibiot. .

Abstract

Introduction: Infections are a major driver of broad-spectrum antibiotic use. This wide use of antibiotics contributes to the emergence of antimicrobial resistance globally that poses a threat to human and animal health. Infections continue to be a major cause of death among pregnant women and neonates. Therefore, this study aimed to assess the burden of extended-spectrum beta-lactamase (ESBL)-producing E. coli and K. pneumoniae carriage among neonates and their surroundings admitted to a referral hospital in Northeast Tanzania.

Methodology: The burden of ESBL-producing E. coli and K. pneumoniae in a neonatal ward was assessed by screening neonates' rectums, maternal and healthcare workers' hands, and neonatal cots. Isolates were cultured, identified, and tested for antimicrobial resistance, while generalized linear models identified risk factors for carriage.

Results: A total of 437 neonates were screened for ESBL-producing E. coli and K. pneumoniae, with 235 (54%) being male. In addition, 77 maternal hand swabs, 118 neonatal cots, and 45 healthcare workers' hand swabs were collected. ESBL-producing K. pneumoniae was isolated from 198 neonates (45%), and E. coli from 96 (23%). Additionally, 5% of maternal hands and 22% of neonatal cots were contaminated with these resistant bacteria. Overall ampicillin resistance was frequent in ESBL-producing E. coli and ESBL K. pneumoniae neonatal colonization (n=261,100%), as was resistance to trimethoprim-sulfamethoxazole (n = 233,89%), gentamicin (n = 169, 66%), and tetracycline (n = 140,54%). Only three (1%) of the ESBL-producing E. coli and ESBL K. pneumoniae isolates were resistant to meropenem. Risk factors significantly associated with carriage of either ESBL-producing E. coli or K. pneumoniae were being born in an admission room [odds ratio (OR)=1.95, confidence interval (CI)=1.31-3.13, p=0.006] and delivery mode, with vaginal delivery associated with a reduced risk of carriage (OR=0.57, CI=0.35-0.92, p=0.023).

Conclusion: The study reveals a high burden of ESBL-producing K. pneumoniae and E. coli in neonates and their environment, with frequent resistance to ampicillin and gentamicin. Hospital admission and cesarean delivery increase the risk of carriage, while vaginal delivery lowers it. Active screening upon admission and advanced diagnostic methods can help reduce transmission and guide effective antimicrobial treatment.

Keywords: antimicrobial susceptibility; burden; extended-spectrum beta-lactamase (ESBL); neonates; risk factor.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

    1. Andriatahina T., Randrianirina F., Hariniana E. R., Talarmin A., Raobijaona H., Buisson Y., et al. (2010). High prevalence of fecal carriage of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a pediatric unit in Madagascar. BMC Infect. Dis. 10, 204. doi: 10.1186/1471-2334-10-204 - DOI - PMC - PubMed
    1. Farra A., Frank T., Tondeur L., Bata P., Gody J., Onambale M. (2016). High rate of faecal carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae in healthy children in Bangui, Central African Republic. Clin. Microbiol. Infect. 22, 891.e1–891.e4. doi: 10.1016/j.cmi.2016.07.001 - DOI - PubMed
    1. Fernández-Reyes M., Vicente D., Gomariz M., Matee TG, Legido-Quigley H, Mboera LEG, et al. (2014). High rate of fecal carriage of extended-spectrum-β-lactamase-producing Escherichia coli in healthy children in Gipuzkoa, northern Spain. Antimicrob. Agents Chemother. 58, 1822–1824. doi: 10.1016/j.eimc.2017.05.005 - DOI - PMC - PubMed
    1. Hartig F. (2022). Residual diagnostics for hierarchical (multi-level/mixed) regression models. R package version 0.4.6. Available from https://CRAN.R-project.org/package=DHARMa
    1. Herindrainy P., Randrianirina F., Ratovoson R., Hariniana E. R., Buisson Y., Genel N., et al. (2011). Rectal carriage of extended-spectrum beta-lactamase-producing gram-negative bacilli in community settings in Madagascar. PloS One 6, e22738. doi: 10.1371/journal.pone.0022738 - DOI - PMC - PubMed

LinkOut - more resources