Published in PLOS One on 2026-08-13, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Yordanos Getachew, Tamirat Tamiru, Mekdelawit Fisseha, Sami Sebri, Tadesse Shume, Regasa Diriba, Kassu Desta
Source: PLOS One • DOI 10.1371/journal.pone.0356234
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Multidrug-resistant Enterobacteriaceae (MDRE) is among the leading causes of hospital-acquired infections, resulting in prolonged hospitalization, increased healthcare costs, and mortality. Carbapenem are often used as last-resort antibiotics; however, the emergence of carbapenemase-producing Enterobacteriaceae (CPE) has severely limited treatment options. In Ethiopia, data on their burden from routine diagnostic laboratory settings remain limited. This study assessed the prevalence of multidrug-resistant and carbapenemase-producing Enterobacteriaceae among clinical isolates in Addis Ababa.
A laboratory-based cross-sectional study was conducted from January 2, 2025, to April 2, 2025 on clinical specimens referred to Wudassie Advanced Medical Laboratory in Addis Ababa, Ethiopia. A total of 1105 clinical specimens collected through convenience sampling method were processed. Bacterial identification was performed using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) (EXS 3000, Zybio Inc., China). Antimicrobial susceptibility testing was conducted using the Kirby–Bauer disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI 2024) guidelines. Carbapenemase production was confirmed using the modified Carbapenem Inactivation Method (mCIM). Data were analyzed using SPSS version 26.
Of the 1105 clinical specimens, 288/1105 (26.1%) showed bacterial growth. Enterobacteriaceae accounted for 156/288 (54.2%) of the isolates. The most common isolates were Escherichia coli 89/156 (57.1%) and Klebsiella pneumoniae 47/156 (30.1%). Overall, 123/156 (78.8%) of Enterobacteriaceae were multidrug resistant. Carbapenem resistance was detected in 35/154 (22.7%) of isolates, and 30/154 (19.5%) were confirmed as carbapenemase producers. Klebsiella pneumoniae 24/30 (80%) was the predominant carbapenemase-producing organism. Most CPE isolates were recovered from urine specimens, followed by wound and sputum samples.
This study demonstrates a high prevalence of multidrug-resistant and carbapenemase-producing Enterobacteriaceae in Addis Ababa. The findings highlight the urgent need for strengthened antimicrobial stewardship programs, early detection strategies, and enhanced infection prevention and control measures in the private health facilities.
Introduction
Antimicrobial resistance (AMR) has become one of the most serious global public health threats, compromising the effectiveness of modern medicine. The inappropriate and excessive use of antimicrobial agents has accelerated the emergence and spread of resistant pathogens, leading to increased mortality, prolonged hospitalization, and substantial healthcare costs [1].
Among resistant organisms, multidrug-resistant (MDR) Enterobacteriaceae represent a major public health concern due to their widespread occurrence in both hospital and community settings. These pathogens commonly exhibit resistance to multiple antibiotic classes, severely limiting therapeutic options [2]. Carbapenem are considered last-resort antibiotics for severe infections caused by extended-spectrum β-lactamase (ESBL)-producing Gram-negative bacteria. However, the global emergence and spread of carbapenemase-producing Enterobacteriaceae (CPE) have significantly reduced the effectiveness of these agents [3].
The global burden of AMR remains substantial. In 2019, bacterial AMR was associated with an estimated 4.95 million deaths worldwide, with the highest burden reported in sub-Saharan Africa [4]. Carbapenem-resistant Enterobacteriaceae, particularly Carbapenem-resistant Klebsiella pneumoniae, are of major concern, with reported mortality rates ranging from 37.2% to 42.1% and a high number of infections and deaths globally [5].Despite this burden, treatment options remain limited, and optimal therapeutic strategies for Carbapenem-resistant infections are still evolving [6].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider technology & industry desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Yordanos Getachew, Tamirat Tamiru, Mekdelawit Fisseha, Sami Sebri, Tadesse Shume, Regasa Diriba, Kassu Desta. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Fecal carriage of ESBL and Carbapenemase-producing Enterobacteriaceae, and its associated factors among hospital and non-hospital janitors at the University of Gondar, Northwest Ethiopia: A comparative cross-sectional study
- Evidence brief: Bacterial isolates and antimicrobial susceptibility profiles of pediatric meningitis at comprehensive specialized hospitals in Bahir Dar, Northwest Ethiopia
- Evidence brief: Genomic epidemiology of multidrug-resistant and ESBL-producing Proteus mirabilis in a military referral hospital in Ethiopia
