Carriage of extended-spectrum beta-lactamases (ESBL)-producing Enterobacteriaceae by healthy children can increase the risk of developing a lethal pathological infection. The objective of this study was to determine the rate of ESBL-producing Enterobacteriaceae carriage among children in remote villages in western Cameroon. We collected fresh stool samples from 110 healthy primary school children between 2 to 5 years old in two remote villages. The bacteria isolates were characterized using the Api 20E gallery, disc diffusion, and double-disc synergy test. Logistic regression analysis was used to determine the risk factors associated with the carriage of ESBL-producing Enterobacteriaceae. Data analysis indicated that a total of 24 children in 110 (22%) investigated were positive to ESBL-producing Enterobacteriaceae. Moreover, 24 (67%) out of 36 bacteria isolates were ESBL producers and 15 (61%) out of 24 being Escherichia coli. Other ESBL-producing bacteria were Klebsiella pneumoniae (3%) and Kluyvera spp (3%). We also isolated a small proportion of bacteria showing resistance to high-level cephalosporins, which overall represented 33% of the total bacteria isolates. Furthermore, risk factors associated with the carriage of ESBL-producing Enterobacteriaceae were the use of pesticides in agriculture and farming practice. The current result suggests that frequent contact to antibiotics is not the only reason for the development of resistance and confirm that resistance can be induced by chemicals from pesticide origin.

Background: Higher carriage rate of extended spectrum beta-lactamases (ESBL)-producing Enterobacteriaceae have already been reported among healthy community children, thus can increases the risk of developing pathological infection. Since children are the most exposed population due to lack of hygiene knowledge, determining their carriage prevalence will limit the progression or development of those pathologies. The objective of this study was to determine the prevalence of ESBL-producing Enterobacteriaceae carriage among children in remote villages of western Cameroon where healthcare structures are absent and the use of antibiotic consumption rare.Methods: A total of 110 fresh stool samples were collected from 110 healthy primary school children between ages 2 to 5 years old from two remote villages. Upon screening using selective agar media for ESBL, Enterobacteriaceae were identified using the Api 20E gallery. Antibiotic susceptibility was investigated using the disc diffusion technique and the ESBL production was determined using the double-disc synergy test. Chi-square test was used for comparison.Results: Children had no history of hospitalization and had not been subjected to antibiotic treatment three months prior to this study. Data analysis indicated a 22% carriage rate for ESBL-producing Enterobacteriaceae among school children. Overall, 24 (67%) out of 36 isolates were ESBL producers and 15 (61%) out of 24 being Escherichia coli. Other ESBLproducing bacteria were Klebsiella pneumoniae (3%) and Kluyvera spp (3%). We also isolated small proportion of bacteria showing resistance to high level cepholosporinase, which overall represented 33% of the total bacteria isolate.Conclusions: The higher carriage of ESBL-producing Enterobacteriaceae in children from some isolated villages devoid of health care structure highlights the risk for resistance transmission between pathogenic and non-pathogenic bacteria. This study also indicates that farming conditions can induces resistance. The current result may contribute to design a therapeutic policy to curtail the emergence of ESBL-producing Enterobacteriaceae in remote villages in western Cameroon.

Background: Commensal flora colonization during hospitalization by bacteria is the first step for a nosocomial infections while antibiotic resistance reduces therapeutic options. In aim to control this phenomenon, we initiated this study to describe the impact of hospitalization on colonization by methicillin-resistant Staphylococcus in the surgical department in 03 health facilities of the Ndé division, west-Cameroon. Methods: This quasi-experimental study was carried out on patients admitted for surgery in 03 health facilities of the Ndé division, west-Cameroon (District Hospital of Bangangté, Protestant Hospital of Bangwa and Cliniques Universitaires des Montagnes). After obtaining ethical clearance and authorizations, nasal swabs were performed at admission and discharge, with the aim of isolating bacteria and performing their antibiotic susceptibility tests. Information on each participant's antibiotic therapy was recorded. Laboratory investigations were carried out according to standard protocols (CASFM, 2019). Results: The most commonly used antibiotics were β-lactam antibiotics. Of the 52 patients who agreed to participate in the study, 104 nasal swabs were performed. From the analysis, 110 (57 at admission versus 53 at discharge) Staphylococcus isolates were obtained. Overall, susceptibility testing showed that antibiotic resistance rates were higher at discharge than at admission; with significant differences between the susceptibility profiles obtained at admission and discharge for β-lactam antibiotics and not significant for fluoroquinolones and aminoglycosides. The nasal flora of 13 (25%) patients was colonized with methicillin-resistant Staphylococcus at admission versus 39 (75%) at discharge and 14 (24.56%) of the isolates obtained at admission were methicillin-resistant versus 37 (69.81%) at discharge. Of the variables studied, hospital stay remained the only variable significantly (p=0.0080) associated with colonization by methicillin-resistant Staphylococcus.Conclusion: This work must be considered as an alarm bell regarding the role of health structures in the colonization and spread of multi-resistant bacteria in Ndé division. As a result, further investigations aimed at investigating the factors favouring this phenomenon should be carried out with an approach similar to that of the ONE HEALTH concept. Pending these investigations, we recommend strict compliance with hygiene rules, personalized antibiotic therapy (performing antibiotic susceptibility tests) and an updated antibiotic prophylaxis and probabilistic antibiotic therapy according to the studies carried out in the locality.