Background: Carbapenemase-producing
Enterobacteriaceae (CPE) are an important and increasing threat to global
health. They are nowadays more encountered routinely in hospitals and cause
high morbidity and mortality due to limited therapeutic alternatives. This
study sought to determine the prevalence of CPE in Yaoundé teaching hospital,
Cameroon, and the associated risk factors.Materials and Method: To achieve this goal, a descriptive cross-sectional study coupled to an
analytical component with consecutive collection of Enterobacteria strains was carried out during a three-month
period (from 27thJuly to 24thOctober 2018) in the University Teaching
Hospital of Yaoundé,
Cameroon. The oxidase and biochemical identification tests usinga miniaturized Api 20 E system were performed on colonies grown on Eosin
Methylene Blue (EMB) medium and subcultured on nutrient agar. Drug
susceptibility testing was carried out according to the Antibiogram Committee of the French Society of Microbiology (CA-SFM
2018.V.2.0). The detection
References
[1]
World Health Organization (2019) New Report Calls for Urgent Action to Avert Antimicrobial Resistance Crisis. https://www.who.int/news/item/29-04-2019-new-report-calls-for-urgent-action-to-avert-antimicrobial-resistance-crisis
[2]
American Society for Microbiology (2009) Antibiotic Resistance: An Ecological Perspective on an Old Problem. http://www.asm.org/
[3]
Nordmann, P. (2014) Carbapenemase-Producing Enterobacteriaceae: Overview of a Major Public Health Challenge. Médecine et Maladies Infectieuse, 44, 51-56. https://doi.org/10.1016/j.medmal.2013.11.007
[4]
Munoz-Price, L. S., Poirel, L., Bonomo, R.A., Schwaber, M.J., Daikos, G.L., Cormican, M., et al. (2013) Clinical Epidemiology of the Global Expansion of Klebsiella pneumonia Carbapenemases. The Lancet Infectious Diseases, 13, 785-796. https://doi.org/10.1016/S1473-3099(13)70190-7
[5]
Martinez-Martinez, L. (2008) Extended-Spectrum β-Lactamases and the Permeability Barrier. Clinical Microbiology and Infection, 14, 82-89. https://doi.org/10.1111/j.1469-0691.2007.01860.x
[6]
Nordmann, P., Cuzon, G. and Naas, T. (2009) The Real Threat of Klebsiella pneumonia Carbape-Nemase Producing Bacteria. The Lancet Infectious Diseases, 9, 228-236. https://doi.org/10.1016/S1473-3099(09)70054-4
[7]
Poirel, L., Pitout, J.D. and Nordmann, P. (2007) Carbapenemases: Molecular Diversity and Clinical Consequences. Future Medicine, 2, 501-512. https://doi.org/10.2217/17460913.2.5.501
[8]
Albiger, B., Glasner, C., Struelens, M., Grundmann, H. and Monnet, D., The European Survey of Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) Working Group (2015) Carbapenemase-Producing Enterobacteriaceae in Europe: Assessment by National Experts from 38 Countries, May 2015. Eurosurveillance, 20, Article 30062. https://doi.org/10.2807/1560-7917.ES.2015.20.45.30062
[9]
Samra, Z., Ofir, O., Lishtzinsky, Y., Madar-Shapiro, L. and Bishara, J. (2007) Outbreak of Carbapenem-Resistant Klebsiella Pneumoniae Producing KPC-3 in a Tertiary Medical Centre in Israel. International Journal of Antimicrobial Agents, 30, 525-529. https://doi.org/10.1016/j.ijantimicag.2007.07.024
[10]
Zeng, L., Yang, C., Zhang, J., Hu, K., Zou, J., Li, J., Wang, J., Huang, W., Yin, L. and Zhang, X. (2021) An Outbreak of Carbapenem-Resistant Klebsiella Pneumoniae in an Intensive Care Unit of a Major Teaching Hospital in Chongqing, China. Frontiers in Cellular and Infection Microbiology, 11, Article 656070. https://doi.org/10.3389/fcimb.2021.656070
[11]
Manenzhe, R.I., Zar, H.J., Nicol, M.P. and Kaba, M. (2015) The Spread of Carbapenemase-Producing Bacteria in Africa: A Systematic Review. Journal of Antimicrobial Chemotherapy, 70, 23-40. https://doi.org/10.1093/jac/dku356
Soukaina, T. (2019) Epidemiologie des Enterobacteries Multiresistantes Productrices de Carbapenemase à l’HIT. These No. 187, Universite Cadi Ayyad, Marrakech. http://wd.fmpm.uca.ma/biblio/theses/annee-htm//FT/2019/these187-19.pdf
[14]
Idomir, M., Taus, N., Burducea, S., Stan, D., Dumitru, L., Drilea, A. and Törok, C. (2002) Studiu asupra sensibilitatii la antibiotice a enterobacteriilor izolate din diverse produse patologice [Enterobacteria Isolated from Different Pathological Products and Their Sensitivity to Antibiotics]. Bacteriologia, Virusologia, Parazitologia, Epidemiologia, 47, 137-142.
[15]
Holmes, B., Willcox, W.R. and Lapage, S.P. (1978) Identification of Enterobacteriaceae by the API 20E System. Journal of Clinical Pathology, 31, 22-30. https://doi.org/10.1136/jcp.31.1.22
[16]
Comité de l’antibiogramme de la Société Française de Microbiologie. Recommandations 2018 V.2.0. https://www.sfm-microbiologie.org/wp-content/uploads/2018/12/CASFMV2_SEPTEMBRE2018.pdf
[17]
Krumperman, P.H. (1983) Multiple Antibiotic Resistance Indexing of Escherichia coli to Identify High-Risk Sources of Fecal Contamination of Foods. Applied Environmental Microbiology, 46, 165-170. https://doi.org/10.1128/aem.46.1.165-170.1983
[18]
Pajand, O., Darabi, N., Ghobani, R., Bameri, Z., Ebrahimi, A. and Hojabri, Z. (2020) The Emergence of the Hypervirulent Klebsilla pneumonia (hvKp) Strains among Circulating Clonal Complex 147 (CC147) Harbourimg blaNDM/OXA-48 Carbapenemases in a Tertiary Care Center of Iran. Annals of Clinical Microbiology and Antimicrobials, 19, Article No. 12. https://doi.org/10.1186/s12941-020-00349-z
[19]
Djuikoué, et al. (2017) Prévalence of CTX-M Beta-Lactamases in Escherichia coli from Community-Acquired Urinary Tract Infections and Associated Risk Factors among Women in Cameroon. Journal of Epidemiological Research, 3, 51-56. https://doi.org/10.5430/jer.v3n1p51
[20]
Ebongue, C., Dongmo, M., Beyiha, G., Ngaba, G., Nda, J.P. and Adiogo, D. (2015) Evolution de la resistance aux antibiotiques des enterobacteries isolées à l’Hôpital General de Douala de 2005 à 2012. PAMJ: The Pan African Medical Journal, 20, Article 227. https://doi.org/10.11604/pamj.2015.20.227.4770
[21]
Clinical and Laboratory Standards Institute (CLSI) (2016) Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplements. CLSI Document M100S-S26.
[22]
Ruppé, E., Arlet, G. and Andremont, A. (2008) Résistance aux β-lactamines des Escherichia coli responsables d’infections urinaires communautaires au cambodge. Thèse pour le diplome d’etat de docteur en pharmacie, 46-76.
[23]
Nordmann, P., Gniadkowski, M., Ginke, C.G., Poirel, L., Woodford, N. and Miriagou, V., European network on carbapénémases (2012) Identification and Screening of Carbapenemase-Producing Enterobacteriaceae. CMI: Clinical Microbiology and Infection, 18, 432-438. https://doi.org/10.1111/j.1469-0691.2012.03815.x
[24]
Lagha, N. (2015) Etude de la resistance aux antibiotiques des enterobacteries productrices de β-lactamases a spectre etendu (blse) isolees de l’hopital de Laghouat. These de Doctorat, Universite Abou Belkaid Tlemcen, 2014-2015.
[25]
Wilson, H. and Török, M. (2018) Extended-Spectrum β-Lactamase-Producing and Carbapenemase-Producing Enterobacteriaceae. Microbial Genomics, 4, 1-12. https://doi.org/10.1099/mgen.0.000197
[26]
Mbakop, C., Gonsu, H., Toukam, M. and Koulla, S. (2011) Caractérisation phénotypique des entérobactéries productrices de β-Lactamases et de carbapénèmases dans trois hôpitaux de Yaoundé. Dans Mémoire DES de biologie clinique, 36-42.
[27]
Heydari, M., Nasiri, M.J., Dabiri, H. and Tarashi, S. (2018) Prevelance of Drug-Resistant Klebsiella pneumoniae in Iran: A Review Article. Iranion Journal of Public Health, 47, 317-326.
[28]
Nordmann, P. and Poirel, L. (2014) The Difficult-to-Control Spread of Carbapenemase Producers among Enterobacteriaceae Worldwide. Clinical Microbiology and Infection, 20, 821-830. https://doi.org/10.1111/1469-0691.12719
[29]
Maamar, B., Abdelmalek, R., Messadi, A.A. and Thabet, L. (2019) Etude epidemiologique des infections a enterobacteries procdutrices de carbapenemases chez les brules. Annals of Burns and Fire Disasters, 32, 10-16.
[30]
Ben Sallem, R., Laribi, B., Arfaoui, A., Ben Khelifa Melki, S., Ouzari, H.I., Ben Slama, K., Naas, T. and Klibi, N. (2022) Co-Occurrence of Genes Encoding Carbapenemase, ESBL, pAmpC and Non-β-Lactam Resistance among Klebsiella pneumonia and E. coli Clinical Isolates in Tunisia. Letters in Applied Microbiology, 74, 729-740. https://doi.org/10.1111/lam.13658
[31]
Logan, L.K. and Weinstein, R.A. (2017) The Epidemiology of Carbarpenem-Resistant Enterobacteriaceae: The Impact and Evolution of a Global Menace. The Journal of Infectious Diseases, 215, S28-S36. https://doi.org/10.1093/infdis/jiw282
