| Autor: |
Zemtsa RJ; Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang P.O. Box 96, Cameroon.; Reproductive, Maternal, Newborn and Child Health (ReMARCH) Research Unit, Research Institute of Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé P.O. Box 67, Cameroon., Noubom M; Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang P.O. Box 96, Cameroon.; Dschang District Hospital, Foto, Dschang P.O. Box 43, Cameroon., Founou LL; Reproductive, Maternal, Newborn and Child Health (ReMARCH) Research Unit, Research Institute of Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé P.O. Box 67, Cameroon.; Bioinformatics & Applied Machine Learning Research Unit, EDEN Biosciences Research Institute (EBRI), EDEN Foundation, Yaoundé P.O. Box 8242, Cameroon., Dimani BD; Department of Biomedical Sciences, Higher Institute of Medical Technology, Nkolondom, Yaoundé P.O. Box 188, Cameroon.; Antimicrobial Resistance and Infectious Diseases, Research Institute of Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé P.O. Box 8242, Cameroon., Koudoum PL; Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang P.O. Box 96, Cameroon.; Antimicrobial Resistance and Infectious Diseases, Research Institute of Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé P.O. Box 8242, Cameroon., Mbossi AD; Reproductive, Maternal, Newborn and Child Health (ReMARCH) Research Unit, Research Institute of Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé P.O. Box 67, Cameroon., Kouanfack C; Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang P.O. Box 96, Cameroon.; Central Hospital of Yaoundé, Yaoundé P.O. Box 47, Cameroon., Founou RC; Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang P.O. Box 96, Cameroon.; Antimicrobial Resistance and Infectious Diseases, Research Institute of Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaoundé P.O. Box 8242, Cameroon. |
| Abstrakt: |
The exacerbation of antimicrobial resistance (AMR) is a major public health threat worldwide. In sub-Saharan Africa, there is a scarcity of data regarding multidrug-resistant (resistance to at least one antibiotic of three or more families of antibiotics) as well as extended spectrum β-lactamase-producing Enterobacterales (ESBL-PE), isolated among clinical and asymptomatically healthy patients, especially in women living with HIV (WLHIV) despite their immunocompromised status. The overarching aim of this study was set to determine the prevalence and characterize genotypically multi-drug resistant Enterobacterales (MDR-E) and ESBL- PE isolated from vaginal swabs of WLHIV attending the Yaoundé Central Hospital, Yaoundé, Cameroon. A cross-sectional study was conducted among WLHIV during a four-month periods from 1 February to 31 May 2021. A total of 175 WLHIV, of childbearing age and under antiretroviral treatment were contacted. One hundred and twenty participants (120) were recruited and vaginal swabs were collected from them. After culture on Eosine-Methylen Blue (EMB) agar, the identification of Enterobacterales was performed using API 20E kit. A double-screening of ESBL-PE was performed using a combined disc diffusion method and ROSCO Diagnostica kits. An antibiotic susceptibility test was carried out by disc diffusion as per the Kirby-Bauer method and the β-lactamase resistance genes, bla CTX-M , bla CTX-M-group1-2-9 , bla TEM were molecularly characterized using a conventional Polymerase Chain Reaction (PCR). Overall, 30.83% (37/120) of the included WLHIV were colonized with Enterobacterales and the prevalence of vaginal carriage of MDR Enterobacterales among them was 62.16% (23/37). Among MDR-E isolates, the most prevalent species were E. coli (56.0%; 14/25) and K. pneumoniae (20.0%; 5/25). High rates of resistance to trimethoprim-sulfamethoxazole (96.0%; 24/25), amoxicillin-clavulanic acid (88.0%; 22/25) and gentamicin (72%; 18/25) were observed. The resistance mechanisms detected among these isolates were ESBL (48.0%; 12/25), ESBL+ porin loss (8.0%; 2/25), ESBL+AmpC (24%; 6/25), with bla CTX-M , bla CTX-M-group-1,2,9 being identified at 48.0% (12/25) for each of them and bla TEM at 72.0% (18/25). Our findings confirm the high-prevalence of MDR as well as ESBL-PE isolated in WLHIV, and suggest that a real time monitoring system of antimicrobial resistant bacteria coupled with the reinforcement of infection prevention control (IPC) strategies are needed to sustainably contain these life-threatening pathogens especially in the most vulnerable populations. |
