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Extended-spectrum beta-lactamase- and carbapenemase-producing Enterobacteriaceae clinical isolates in a Senegalese teaching hospital: a cross sectional study.

Objective: Extended spectrum ?-lactamase (ESBL)- and carbapenemase-producing Enterobacteriaceae (CPE) have been increasingly reported worldwide. The objective of this study was to determine the prevalence of these multidrug-resistant strains in a major university teaching hospital in Dakar, Senegal. Material and methods: A total of 1205 Enterobacteriaceae stains were tested for ESBL- and carbapenemase production. Antibiotics susceptibility testing was performed using disk diffusion method. ESBL was detected using a double-disk synergy method. Carbapenemase production was detected using ertapenem 10 µg disk charge. Results: The overall prevalence of ESBL- and carbapenemase-producing Enterobacteriaceae were 26.2% (316/1205) and 5.1% (62/1205), respectively. Interestingly, 3.8% of these pathogens were both ESBL-carbapenemase producers. Among the Enterobacteriaceae ESBL positive, Escherichia coli (45.2%, 143/316), Klebsiella pneumoniae (26.3%, 83/316), Enterobacter cloacae (12.7%, 40/316), and Proteus vulgaris (9.2%, 29/316) were the most prevalent. These strains were mainly isolated from urines (56.6%) and pus (22.7%) specimen. The most prevalent CPE were E. coli (45.2%, 28/62), K. pneumoniae (27.4%, 17/62), and Enterobacter cloacae (16.1%, 10/62) particularly isolated from urine (58%), and pus (19.3%). The majority of these MDR strains were isolated from patients hospitalized in urology (32.4%), surgery (27.7%), internal medicine (18.5%), and intensive care units (10%). ESBL-producing Enterobacteriaceae remain highly susceptible to fosfomycin (94.1%), amikacin (92.5%), and ertapenem (88.6%) while carbapenemase producers were fully susceptible to amikacin (100%), and to a lesser extend to fosfomycin (66.7%) and colistin (60%). Conclusion: Our study revealed increasing prevalence of ESBL- and carbapenemase-producing Enterobacteriaceae with limited therapeutic options, suggesting a need of continuous multi-drug resistant (MDR) surveillance patterns particularly in hospital settings.

Auteur(s) : Camara M, Mane MT, Ba-Diallo A, Dieng A, Diop-Ndiaye H, Karam F, Lo-Lo S, Diagne-Samb H, Ngom-Cisse S, Toure-Kane C, Gaye-Diallo A, Mboup S, Boye
Pages : 1600-5
Année de publication : 2017
Revue : Afr J Microbiol Res
N° de volume : 11(44)
Type : Article
Mise en ligne par : CAMARA Makhtar