The Global One Health initiative (GOHi) is working with two hospitals in Ethiopia to strengthen their ability to detect and respond to organisms resistant to many antibiotics, track infectious disease outbreaks and develop treatment and prevention strategies.
Through the Global Action in Healthcare Network – Antimicrobial Resistance program, which is funded by the U.S. Centers for Disease Control and Prevention, experts from GOHi are showing local scientists how to identify and fight these organisms, specifically a type called carbapenemase producing carbapenem resistant enterobacterales (CP-CRE), which are resistant to many antibiotics and can easily spread from one person to another.
The CP-CREs were tested for types of enzymes responsible for carbapenem resistance at the Ethiopian Public Health Institute and the majority of them were found to be encoded by New Delhi Metallo-β-lactamase (NDM) enzyme. This enzyme is carried on mobile genetic elements, enabling horizontal gene transfer and rapid spread of resistance. These CP-CREs were found to be resistant to most commercially available antimicrobials in Ethiopia, highlighting the urgent need to evaluate second-line antimicrobial agents for treating infections caused by these multi-drug resistance (MDR) pathogens. To address this threat, GOHi recently held a hands-on training on these MDR pathogens to eight microbiologists from the Ethiopian Public Health Institute and two microbiologists from Tikur Anbessa Specialized Hospital and Zewditu Memorial Hospital. Led by Professor Joan-Miquel Balanda with the Ohio State University Wexner Medical Center, the training focused on performing antimicrobial susceptibility testing using “sensititre” plate coated with different concentrations of second-line antimicrobials. The training involved basic principles of antimicrobial susceptibility testing, and practical demonstration on preparation of regents, use of multichannel pipettes, experimental setup and interpretation of results.
The skills and knowledge gained from this training will enable participants to accurately test MDR organisms not responding to available first-line antimicrobials and generate critical data to inform national treatment guidelines on adoption of second-line antimicrobials for patients with limited therapeutic options. This initiative represents a significant step towards strengthening national response to antimicrobial resistance and improving patient outcomes.