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Phenotypic and genotypic characterization of multidrug resistant and extended-spectrum β-lactamase-producing Enterobacterales isolated from clinical samples in the western region in Cameroon

BACKGROUND: The 2017 World Health Organization (WHO) report has listed extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) as critical pathogens for public health and requiring urgently new antibiotics. The aim of this study was to characterize phenotypically and genotypically ESBL-E i...

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Autores principales: Nkengkana, Omer Aurelle, Founou, Raspail Carrel, Founou, Luria Leslie, Dimani, Brice Davy, Koudoum, Patrice Landry, Zemtsa, Jessica Ravalona, Mbossi, Aurelia, Mawout, Cyrielle Signe, Tegang, Larissa Tchakounte, Noubom, Michel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10666389/
https://www.ncbi.nlm.nih.gov/pubmed/37993766
http://dx.doi.org/10.1186/s12879-023-08742-7
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author Nkengkana, Omer Aurelle
Founou, Raspail Carrel
Founou, Luria Leslie
Dimani, Brice Davy
Koudoum, Patrice Landry
Zemtsa, Jessica Ravalona
Mbossi, Aurelia
Mawout, Cyrielle Signe
Tegang, Larissa Tchakounte
Noubom, Michel
author_facet Nkengkana, Omer Aurelle
Founou, Raspail Carrel
Founou, Luria Leslie
Dimani, Brice Davy
Koudoum, Patrice Landry
Zemtsa, Jessica Ravalona
Mbossi, Aurelia
Mawout, Cyrielle Signe
Tegang, Larissa Tchakounte
Noubom, Michel
author_sort Nkengkana, Omer Aurelle
collection PubMed
description BACKGROUND: The 2017 World Health Organization (WHO) report has listed extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) as critical pathogens for public health and requiring urgently new antibiotics. The aim of this study was to characterize phenotypically and genotypically ESBL-E isolated among clinical samples in Dschang, Cameroon. METHODS: A cross-sectional study was conducted during a four-month periods from February to May 2022 in the two biggest hospitals of Dschang. Clinical samples were collected and cultured on Eosin Methylene Blue agar. Suspected growing colonies were biochemically identified using the Enterosystem Kit 18R. Antimicrobial susceptibility testing (AST) was done using the Kirby Bauer disc diffusion method and interpretated according to the CA-SFM recommendations. ESBL phenotypes were double screened using CHROMagar™ ESBL and double disk synergy test (DDST). The detection of resistance genes was performed using conventional and multiplex PCR methods. Results were analyzed with SPSS (version 21) and a p-value < 0.05 was considered statistically significant. RESULTS: A total of 152 Enterobacterales were isolated among 597 clinical samples including urine, blood, cervico-vaginal, urethral swabs and wound samples. The overall prevalence of ESBL-Enterobacterales was 29.61% (45/152). The most represented ESBL species were Escherichia coli (n = 23; 51.11%), Klebsiella pneumoniae (n = 8; 17.78%) and Citrobacter freundii (n = 6; 13.33%). CONCLUSION: This study reveals the high burden of ESBL-E among clinical samples in the regional hospital in Dschang with the most common species being E. coli and K. pneumoniae. It confirmed the high occurrence of bla(CTX−M) and bla(TEM) among ESBL-E. The study suggests that implementing antimicrobial stewardship program and real-time surveillance of antimicrobial resistance are needed in the Western region of Cameroon. Moreover, the implementation of infection prevention and control measures (IPC) is essential to curb the dissemination of these bacteria from community to hospital settings. Implementation of national action plan to fight against antimicrobial resistance at the local levels is urgently needed.
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spelling pubmed-106663892023-11-22 Phenotypic and genotypic characterization of multidrug resistant and extended-spectrum β-lactamase-producing Enterobacterales isolated from clinical samples in the western region in Cameroon Nkengkana, Omer Aurelle Founou, Raspail Carrel Founou, Luria Leslie Dimani, Brice Davy Koudoum, Patrice Landry Zemtsa, Jessica Ravalona Mbossi, Aurelia Mawout, Cyrielle Signe Tegang, Larissa Tchakounte Noubom, Michel BMC Infect Dis Research BACKGROUND: The 2017 World Health Organization (WHO) report has listed extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) as critical pathogens for public health and requiring urgently new antibiotics. The aim of this study was to characterize phenotypically and genotypically ESBL-E isolated among clinical samples in Dschang, Cameroon. METHODS: A cross-sectional study was conducted during a four-month periods from February to May 2022 in the two biggest hospitals of Dschang. Clinical samples were collected and cultured on Eosin Methylene Blue agar. Suspected growing colonies were biochemically identified using the Enterosystem Kit 18R. Antimicrobial susceptibility testing (AST) was done using the Kirby Bauer disc diffusion method and interpretated according to the CA-SFM recommendations. ESBL phenotypes were double screened using CHROMagar™ ESBL and double disk synergy test (DDST). The detection of resistance genes was performed using conventional and multiplex PCR methods. Results were analyzed with SPSS (version 21) and a p-value < 0.05 was considered statistically significant. RESULTS: A total of 152 Enterobacterales were isolated among 597 clinical samples including urine, blood, cervico-vaginal, urethral swabs and wound samples. The overall prevalence of ESBL-Enterobacterales was 29.61% (45/152). The most represented ESBL species were Escherichia coli (n = 23; 51.11%), Klebsiella pneumoniae (n = 8; 17.78%) and Citrobacter freundii (n = 6; 13.33%). CONCLUSION: This study reveals the high burden of ESBL-E among clinical samples in the regional hospital in Dschang with the most common species being E. coli and K. pneumoniae. It confirmed the high occurrence of bla(CTX−M) and bla(TEM) among ESBL-E. The study suggests that implementing antimicrobial stewardship program and real-time surveillance of antimicrobial resistance are needed in the Western region of Cameroon. Moreover, the implementation of infection prevention and control measures (IPC) is essential to curb the dissemination of these bacteria from community to hospital settings. Implementation of national action plan to fight against antimicrobial resistance at the local levels is urgently needed. BioMed Central 2023-11-22 /pmc/articles/PMC10666389/ /pubmed/37993766 http://dx.doi.org/10.1186/s12879-023-08742-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Nkengkana, Omer Aurelle
Founou, Raspail Carrel
Founou, Luria Leslie
Dimani, Brice Davy
Koudoum, Patrice Landry
Zemtsa, Jessica Ravalona
Mbossi, Aurelia
Mawout, Cyrielle Signe
Tegang, Larissa Tchakounte
Noubom, Michel
Phenotypic and genotypic characterization of multidrug resistant and extended-spectrum β-lactamase-producing Enterobacterales isolated from clinical samples in the western region in Cameroon
title Phenotypic and genotypic characterization of multidrug resistant and extended-spectrum β-lactamase-producing Enterobacterales isolated from clinical samples in the western region in Cameroon
title_full Phenotypic and genotypic characterization of multidrug resistant and extended-spectrum β-lactamase-producing Enterobacterales isolated from clinical samples in the western region in Cameroon
title_fullStr Phenotypic and genotypic characterization of multidrug resistant and extended-spectrum β-lactamase-producing Enterobacterales isolated from clinical samples in the western region in Cameroon
title_full_unstemmed Phenotypic and genotypic characterization of multidrug resistant and extended-spectrum β-lactamase-producing Enterobacterales isolated from clinical samples in the western region in Cameroon
title_short Phenotypic and genotypic characterization of multidrug resistant and extended-spectrum β-lactamase-producing Enterobacterales isolated from clinical samples in the western region in Cameroon
title_sort phenotypic and genotypic characterization of multidrug resistant and extended-spectrum β-lactamase-producing enterobacterales isolated from clinical samples in the western region in cameroon
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10666389/
https://www.ncbi.nlm.nih.gov/pubmed/37993766
http://dx.doi.org/10.1186/s12879-023-08742-7
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