喀麦隆西部地区尿路感染分离出的产超广谱β-内酰胺酶和多重耐药大肠埃希菌及肺炎克雷伯菌的高流行率

High prevalence of multidrug resistant and extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolated from urinary tract infections in the West region, Cameroon.

作者信息

Bayaba Solomon, Founou Raspail Carrel, Tchouangueu Flaurant Thibau, Dimani Brice Davy, Mafo Lethicia Danaëlle, Nkengkana Omer Aurelle, Founou Luria Leslie, Noubom Michel

机构信息

Department of Microbiology, Hematology and Immunology, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon.

Antimicrobial Research Unit, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, 4000, South Africa.

出版信息

BMC Infect Dis. 2025 Jan 24;25(1):115. doi: 10.1186/s12879-025-10483-8.

DOI:10.1186/s12879-025-10483-8

PMID:39856593

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11760060/

Abstract

BACKGROUND

Antimicrobial resistance remains a worldwide health problem with serious societal and economical repercussions. Multidrug resistant and Extended-Spectrum β-Lactamase producing-Enterobacterales (ESBL-E) are pathogens of critical public health priority that urgently require the research and development of new drugs. This study aims to determine the prevalence and characterize the genes conferring resistance to β-lactams among Escherichia coli and Klebsiella pneumoniae isolated from patients with urinary tract infections (UTIs) in the West region, Cameroon.

METHODS

A cross-sectional study was conducted among two healthcare facilities during a four-month period from February to May, 2023. All mid-stream urine samples were collected from UTIs patients. The Escherichia coli and K. pneumoniae strains were identified using Enterosystem 18R kit following the manufacturer's instructions. The antimicrobial susceptibility test (AST) was performed using the Kirby-Bauer disk diffusion method. The screening of ESBL production was done using ESBL ChromAgar medium combined with the double-disk synergy test (DDT). Antimicrobial resistance genes were detected using polymerase chain methods. The data analysis was performed using Excel 2016 and IBM SPSS version 20.

RESULTS

A total of 215 urine samples were collected and analyzed during the study period. A 31.62% (68/215) prevalence of Enterobacterales was detected with prevalence of 79.41% (54/68) and 14.70% (10/68) for Escherichia coli and Klebsiella pneumoniae respectively. The overall prevalence of ESBL-Enterobacterales was 64.70% (44/68). About 82% (36/44) of isolates were MDR and high resistance level was observed for amoxicillin + clavulanic acid and ceftazidime. The resistance genes detected were bla, and bla respectively.

CONCLUSION

The findings of this study highlight the high burden of MDR and ESBL-E. coli and K. pneumoniae isolates from UTIs. The study emphasizes the necessity of routine screening and monitoring of antimicrobial resistance in healthcare facilities and community settings. It is therefore crucial to implement antimicrobial stewardship programs in the country and infection prevention and control (IPC) measures in hospital settings.

摘要

背景

抗菌药物耐药性仍然是一个全球性的健康问题，具有严重的社会和经济影响。多重耐药和产超广谱β-内酰胺酶肠杆菌科细菌（ESBL-E）是关键的公共卫生重点病原体，迫切需要研发新药。本研究旨在确定喀麦隆西部地区尿路感染（UTI）患者分离出的大肠埃希菌和肺炎克雷伯菌中β-内酰胺类耐药基因的流行情况并对其进行特征分析。

方法

于2023年2月至5月的四个月期间，在两家医疗机构开展了一项横断面研究。所有中段尿样本均采集自UTI患者。按照制造商的说明，使用Enterosystem 18R试剂盒鉴定大肠埃希菌和肺炎克雷伯菌菌株。采用 Kirby-Bauer 纸片扩散法进行抗菌药物敏感性试验（AST）。使用ESBL ChromAgar培养基结合双纸片协同试验（DDT）进行ESBL产生的筛查。采用聚合酶链反应方法检测抗菌药物耐药基因。使用Excel 2016和IBM SPSS 20版进行数据分析。

结果

研究期间共收集并分析了215份尿液样本。检测到肠杆菌科细菌的流行率为31.62%（68/215），其中大肠埃希菌和肺炎克雷伯菌的流行率分别为79.41%（54/68）和14.70%（10/68）。ESBL-肠杆菌科细菌的总体流行率为64.70%（44/68）。约82%（36/44）的分离株为多重耐药，对阿莫西林+克拉维酸和头孢他啶观察到高耐药水平。检测到的耐药基因分别为bla和bla。