High prevalence and characterization of extended-spectrum ß-lactamase producing Enterobacteriaceae in Chadian hospitals

Oumar Ouchar Mahamat, Manon Lounnas, Mallorie Hide, Yann Dumont, Abelsalam Tidjani, Kadidja Kamougam, Madina Abderrahmane, Julio Benavides, Jérôme Solassol, Anne Laure Bañuls, Hélène Jean-Pierre, Christian Carrière, Sylvain Godreuil

Resultado de la investigación: Article

Resumen

Background: Extended-spectrum ß-lactamase-producing Enterobacteriaceae (ESBL-PE) represent a major problem in the management of nosocomial infections. However, ESBL-PE are not systematically monitored in African countries. The aim of this study was to determine ESBL-PE prevalence in patients from three hospitals in N'Djamena, the capital city of Chad, and to characterize the genetic origin of the observed resistance. Methods: From January to March 2017, 313 non-duplicate isolates were recovered from various clinical specimens obtained from 1713 patients in the three main hospitals of N'Djamena. Bacterial species were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Susceptibility to 28 antibiotics was tested using the disk diffusion method on Müller-Hinton agar, and ESBL production was confirmed with the double-disc synergy test. The most prevalent ESBL genes associated with the observed resistance were detected using multiplex PCR followed by double-stranded DNA sequencing. Results: Among the 313 isolates, 197 belonged to the Enterobacteriaceae family. The overall ESBL-PE prevalence was 47.72% (n = 94/197), with a higher rate among inpatients compared with outpatients (54.13% vs. 34.37%). ESBL-PE prevalence was highest in older patients (≥60 years of age). E. coli was the most common ESBL-producer organism (63.8%), followed by K. pneumoniae (21.2%). ESBL-PE were mainly found in urine samples (75%). The CTX-M-1 group was dominant (96.7% of the 94 ESBL-PE isolates, CTX-M-15 enzyme), followed by the CTX-M-9 group (4.1%). 86% of resistant isolates harbored more than one ESBL-encoding gene. ESBL production was also associated with the highest levels of resistance to non-β-lactam drugs. Conclusions: The prevalence of ESBL-PE harboring resistant genes encoding ESBLs of the CTX-M-1 group was high (48%) among clinical isolates of three main hospitals in Chad, suggesting an alarming spread of ESBL-PE among patients.

Idioma originalEnglish
Número de artículo3838
PublicaciónBMC Infectious Diseases
Volumen19
N.º1
DOI
EstadoPublished - 28 feb 2019

Huella dactilar

Enterobacteriaceae
Chad
Genes
Lactams
Multiplex Polymerase Chain Reaction
Cross Infection
DNA Sequence Analysis
Agar
Inpatients
Mass Spectrometry
Pneumonia
Lasers
Outpatients
Urine
Escherichia coli
Anti-Bacterial Agents
DNA
Enzymes
Pharmaceutical Preparations
beta-lactamase TEM-3

ASJC Scopus subject areas

  • Infectious Diseases

Citar esto

Mahamat, Oumar Ouchar ; Lounnas, Manon ; Hide, Mallorie ; Dumont, Yann ; Tidjani, Abelsalam ; Kamougam, Kadidja ; Abderrahmane, Madina ; Benavides, Julio ; Solassol, Jérôme ; Bañuls, Anne Laure ; Jean-Pierre, Hélène ; Carrière, Christian ; Godreuil, Sylvain. / High prevalence and characterization of extended-spectrum ß-lactamase producing Enterobacteriaceae in Chadian hospitals. En: BMC Infectious Diseases. 2019 ; Vol. 19, N.º 1.
@article{68618d26b1a64a1b945ad3448bb19698,
title = "High prevalence and characterization of extended-spectrum {\ss}-lactamase producing Enterobacteriaceae in Chadian hospitals",
abstract = "Background: Extended-spectrum {\ss}-lactamase-producing Enterobacteriaceae (ESBL-PE) represent a major problem in the management of nosocomial infections. However, ESBL-PE are not systematically monitored in African countries. The aim of this study was to determine ESBL-PE prevalence in patients from three hospitals in N'Djamena, the capital city of Chad, and to characterize the genetic origin of the observed resistance. Methods: From January to March 2017, 313 non-duplicate isolates were recovered from various clinical specimens obtained from 1713 patients in the three main hospitals of N'Djamena. Bacterial species were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Susceptibility to 28 antibiotics was tested using the disk diffusion method on M{\"u}ller-Hinton agar, and ESBL production was confirmed with the double-disc synergy test. The most prevalent ESBL genes associated with the observed resistance were detected using multiplex PCR followed by double-stranded DNA sequencing. Results: Among the 313 isolates, 197 belonged to the Enterobacteriaceae family. The overall ESBL-PE prevalence was 47.72{\%} (n = 94/197), with a higher rate among inpatients compared with outpatients (54.13{\%} vs. 34.37{\%}). ESBL-PE prevalence was highest in older patients (≥60 years of age). E. coli was the most common ESBL-producer organism (63.8{\%}), followed by K. pneumoniae (21.2{\%}). ESBL-PE were mainly found in urine samples (75{\%}). The CTX-M-1 group was dominant (96.7{\%} of the 94 ESBL-PE isolates, CTX-M-15 enzyme), followed by the CTX-M-9 group (4.1{\%}). 86{\%} of resistant isolates harbored more than one ESBL-encoding gene. ESBL production was also associated with the highest levels of resistance to non-β-lactam drugs. Conclusions: The prevalence of ESBL-PE harboring resistant genes encoding ESBLs of the CTX-M-1 group was high (48{\%}) among clinical isolates of three main hospitals in Chad, suggesting an alarming spread of ESBL-PE among patients.",
keywords = "Chad, Clinical samples, Enterobacteriaceae, ESBL, Prevalence",
author = "Mahamat, {Oumar Ouchar} and Manon Lounnas and Mallorie Hide and Yann Dumont and Abelsalam Tidjani and Kadidja Kamougam and Madina Abderrahmane and Julio Benavides and J{\'e}r{\^o}me Solassol and Ba{\~n}uls, {Anne Laure} and H{\'e}l{\`e}ne Jean-Pierre and Christian Carri{\`e}re and Sylvain Godreuil",
year = "2019",
month = "2",
day = "28",
doi = "10.1186/s12879-019-3838-1",
language = "English",
volume = "19",
journal = "BMC Infectious Diseases",
issn = "1471-2334",
publisher = "BioMed Central",
number = "1",

}

Mahamat, OO, Lounnas, M, Hide, M, Dumont, Y, Tidjani, A, Kamougam, K, Abderrahmane, M, Benavides, J, Solassol, J, Bañuls, AL, Jean-Pierre, H, Carrière, C & Godreuil, S 2019, 'High prevalence and characterization of extended-spectrum ß-lactamase producing Enterobacteriaceae in Chadian hospitals', BMC Infectious Diseases, vol. 19, n.º 1, 3838. https://doi.org/10.1186/s12879-019-3838-1

High prevalence and characterization of extended-spectrum ß-lactamase producing Enterobacteriaceae in Chadian hospitals. / Mahamat, Oumar Ouchar; Lounnas, Manon; Hide, Mallorie; Dumont, Yann; Tidjani, Abelsalam; Kamougam, Kadidja; Abderrahmane, Madina; Benavides, Julio; Solassol, Jérôme; Bañuls, Anne Laure; Jean-Pierre, Hélène; Carrière, Christian; Godreuil, Sylvain.

En: BMC Infectious Diseases, Vol. 19, N.º 1, 3838, 28.02.2019.

Resultado de la investigación: Article

TY - JOUR

T1 - High prevalence and characterization of extended-spectrum ß-lactamase producing Enterobacteriaceae in Chadian hospitals

AU - Mahamat, Oumar Ouchar

AU - Lounnas, Manon

AU - Hide, Mallorie

AU - Dumont, Yann

AU - Tidjani, Abelsalam

AU - Kamougam, Kadidja

AU - Abderrahmane, Madina

AU - Benavides, Julio

AU - Solassol, Jérôme

AU - Bañuls, Anne Laure

AU - Jean-Pierre, Hélène

AU - Carrière, Christian

AU - Godreuil, Sylvain

PY - 2019/2/28

Y1 - 2019/2/28

N2 - Background: Extended-spectrum ß-lactamase-producing Enterobacteriaceae (ESBL-PE) represent a major problem in the management of nosocomial infections. However, ESBL-PE are not systematically monitored in African countries. The aim of this study was to determine ESBL-PE prevalence in patients from three hospitals in N'Djamena, the capital city of Chad, and to characterize the genetic origin of the observed resistance. Methods: From January to March 2017, 313 non-duplicate isolates were recovered from various clinical specimens obtained from 1713 patients in the three main hospitals of N'Djamena. Bacterial species were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Susceptibility to 28 antibiotics was tested using the disk diffusion method on Müller-Hinton agar, and ESBL production was confirmed with the double-disc synergy test. The most prevalent ESBL genes associated with the observed resistance were detected using multiplex PCR followed by double-stranded DNA sequencing. Results: Among the 313 isolates, 197 belonged to the Enterobacteriaceae family. The overall ESBL-PE prevalence was 47.72% (n = 94/197), with a higher rate among inpatients compared with outpatients (54.13% vs. 34.37%). ESBL-PE prevalence was highest in older patients (≥60 years of age). E. coli was the most common ESBL-producer organism (63.8%), followed by K. pneumoniae (21.2%). ESBL-PE were mainly found in urine samples (75%). The CTX-M-1 group was dominant (96.7% of the 94 ESBL-PE isolates, CTX-M-15 enzyme), followed by the CTX-M-9 group (4.1%). 86% of resistant isolates harbored more than one ESBL-encoding gene. ESBL production was also associated with the highest levels of resistance to non-β-lactam drugs. Conclusions: The prevalence of ESBL-PE harboring resistant genes encoding ESBLs of the CTX-M-1 group was high (48%) among clinical isolates of three main hospitals in Chad, suggesting an alarming spread of ESBL-PE among patients.

AB - Background: Extended-spectrum ß-lactamase-producing Enterobacteriaceae (ESBL-PE) represent a major problem in the management of nosocomial infections. However, ESBL-PE are not systematically monitored in African countries. The aim of this study was to determine ESBL-PE prevalence in patients from three hospitals in N'Djamena, the capital city of Chad, and to characterize the genetic origin of the observed resistance. Methods: From January to March 2017, 313 non-duplicate isolates were recovered from various clinical specimens obtained from 1713 patients in the three main hospitals of N'Djamena. Bacterial species were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Susceptibility to 28 antibiotics was tested using the disk diffusion method on Müller-Hinton agar, and ESBL production was confirmed with the double-disc synergy test. The most prevalent ESBL genes associated with the observed resistance were detected using multiplex PCR followed by double-stranded DNA sequencing. Results: Among the 313 isolates, 197 belonged to the Enterobacteriaceae family. The overall ESBL-PE prevalence was 47.72% (n = 94/197), with a higher rate among inpatients compared with outpatients (54.13% vs. 34.37%). ESBL-PE prevalence was highest in older patients (≥60 years of age). E. coli was the most common ESBL-producer organism (63.8%), followed by K. pneumoniae (21.2%). ESBL-PE were mainly found in urine samples (75%). The CTX-M-1 group was dominant (96.7% of the 94 ESBL-PE isolates, CTX-M-15 enzyme), followed by the CTX-M-9 group (4.1%). 86% of resistant isolates harbored more than one ESBL-encoding gene. ESBL production was also associated with the highest levels of resistance to non-β-lactam drugs. Conclusions: The prevalence of ESBL-PE harboring resistant genes encoding ESBLs of the CTX-M-1 group was high (48%) among clinical isolates of three main hospitals in Chad, suggesting an alarming spread of ESBL-PE among patients.

KW - Chad

KW - Clinical samples

KW - Enterobacteriaceae

KW - ESBL

KW - Prevalence

UR - http://www.scopus.com/inward/record.url?scp=85062288339&partnerID=8YFLogxK

U2 - 10.1186/s12879-019-3838-1

DO - 10.1186/s12879-019-3838-1

M3 - Article

VL - 19

JO - BMC Infectious Diseases

JF - BMC Infectious Diseases

SN - 1471-2334

IS - 1

M1 - 3838

ER -