Intestinal carriage of Extended Spectrum Beta-Lactamase producing E. coli in women with urinary tract infections, Cameroon

Abstract

Introduction: During the last decade, the prevalence of the intestinal carriage of extended spectrum beta-lactamases -producing Escherichia coli (ESBL-E. coli) has continued to increase worldwide in the community, especially in developing countries. Hence, we undertook a study to determine the ESBL-E. coli fecal carriage rate and the associated risk factors in Cameroonian women. Methodology: A total of 86 women suspected of community-acquired urinary tract infections (UTI) were included in 10 health structures from May 2011 to April 2012. After filling a questionnaire, they provided a stool sample that was plated on selective media for ESBL producing bacteria. The identification of strains was obtained with mass spectrometry and the antibiotic susceptibility by disk diffusion in agar media. The ESBL type was determined by PCR. The relative abundance of ESBL-E. coli was measured for positive samples. Eventually, the presence of antibiotics in stool was assessed. Results: The carriage rate of ESBL-E. coli was 57/86 (66.3%). Phenotypic and molecular characterization showed that all ESBL-E. coli strains contained group 1 CTX-M enzymes. Multivariate analysis showed that ESBL-E. coli fecal carriage was associated with the presence of antibiotics in stools (p < 0.05). Although not significant, mean ESBL relative abundance tended to be higher in patients with antibiotic exposure. Conclusions: Our results show that the carriage of ESBL-E. coli fecal carriage in women with UTI suspicion from the Cameroonian community is extremely high and associated with recent antibiotic intake.

Digital Profile of Klebsiella Pneumoniae Strains Producing Extended Spectrum β-Lactamase Isolated in Hospitals in the Littoral Region of Cameroon

“…ESBL production in our study was 86.9%, comparable to Feizabadi in Iran in the order of 72.1% for K. pneumoniae [11], Dadeic-Ljubovic in Bosnia and Herzegovina with 88, 8% in enterobacteria [12]. In the same order as Elhani reports in Tunisia; the production of ESBL by K. pneumoniae varies and can reach 87.5% in pediatric intensive care units [13], a study conducted in Yaoundé (Cameroon) gave a rate of 66.3% [14] Hailaji reports that 20.4% of ESBL are produced by Klebsiella species in Nouakchott, Mauritania [15] and its production in Sudan was 44.4% [16]. Thus, ESBL prevalence rates vary widely according to geographical location and bacterial species and there is a causal link between the increased use of third-generation cephalosporins and the emergence of ESBLs.…”

Determination of antibiotic resistance genes and virulence factors in Escherichia coli isolated from Turkish patients with urinary tract infection

“…E. coli is the most prevalent etiologic agent of UTIs. The virulence of UTI inducing E. coli strains is due to their expression of virulence factors 4,23 .…”

Prevalence of CTX-M beta-Lactamases in Escherichia coli from community-acquired urinary tract infections and associated risk factors among women in Cameroon

“…[2,[6][7][8] Few studies have been done on ESBL however they only looked at intestinal carriage. [9][10][11] The prevalence of CTX-M in E. coli strains responsible for community-acquired UTI in Cameroon or Central Africa has not been documented. The aim of our study was to determine the prevalence of bla CTX-M-type in E. coli strains in community-acquired urinary tract infections in women as well as its risk factors in Cameroon.…”