Occurrence of extended-spectrum β-lactamase (ESBL) and carbapenemase-producing Escherichia coli isolated from childhood diarrhoea in Yaoundé, Cameroon

Abstract

<title>Abstract</title> <bold>Introduction:</bold> Extended-spectrum β-lactamase (ESBL)-producing pathogenic E. coli is a global public health issue, especially in sub-Saharan African countries such as Cameroon. It contributes to increase hospital length of stay, morbidity, mortality, and economic costs because of treatment failures. This study aims at determining the resistance and virulence profiles of ESBL-E. coli among childhood diarrhoea during the cholera outbreak in Yaoundé, Cameroon. <bold>Materials and Methods</bold>: During a four-month period from March 1st to June 30^th, 2023, stool samples were collected from 90 under five children presenting clinical signs of gastroenteritis and attending four hospitals in Yaoundé, Cameroon. Bacterial identification was done using API20E and antimicrobial susceptibility test was performed using the Kirby-Bauer disc diffusion method. After extraction, genomic DNA was subjected to conventional and multiplex polymerase chain reaction (PCR) for detection of resistance and virulence genes. Statistical analysis was performed using Epi info^TM (7.2.5.0). Statistical significance was considered at a p-value &lt;0.05. <bold>Results:</bold> Out of 150 patients contacted, 90 patients were enrolled, 84 samples were collected, 52.38%(44/84) and 3.57%(03/84) were confirmed as extended-spectrum β-lactamase and carbapenemase-producing E. coli respectively. The risk factors were analyzed, and children who drank natural fruit juice (OR: 0.4, p-value: 0.03) were found to be significantly associated with ESBL-Ec. The ESBL-Ec isolates showed a high level of resistance to amoxicillin-clavulanic acid, cefotaxime, ceftazidime, cefepime, colistin, and tetracycline. The bla_CTX-Mwas more prevalent ß-lactamase resistance gene. The tetracycline resistance genes tet(A) and tet(B) were also detected. The most important virulence genes detected were FimH (81.81%) and papA (79.54%). <bold>Conclusion:</bold> These findings suggest implementing routine surveillance and screening for antimicrobial resistance. Antimicrobial stewardship strategies (ASP) need to be implemented to curb the emergence and dissemination of ESBL-Ec. In addition, a national surveillance program for antimicrobial resistance needs to be implemented at local and regional levels in order to reduce morbidity in Cameroon.