Carriage of extended spectrum beta-lactamase-producing Enterobacteriaceae by healthy school children from two remote villages in western Cameroun

Abstract

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.