Epidemiology of Community Origin Escherichia coli and Klebsiella pneumoniae Uropathogenic Strains Resistant to Antibiotics in Franceville, Gabon

Abstract

Introduction Urinary tract infection is one of the major causes of consultation, microbiologic exploration, intensive use of antibiotics worldwide, and the second leading cause of clinical consultation in community practice. Many bacteria play a role in the urinary tract infections etiology, including Enterobacteriaceae such as Escherichia coli ( E. coli ) and Klebsiella spp. Objective The study’s main objective was to examine the epidemiology of E. coli and Klebsiella pneumoniae ( K. pneumoniae ) uropathogenic strains resistant to antibiotics in Franceville. Methodology The study was carried out between January 2018 and June 2019 in Franceville South-East Gabon. We examined a total of 1086 cytobacteriological urine samples. The identification of E. coli and K. pneumoniae strains was carried out using the Vitek-2 compact automated system and the antibiogram with the disk diffusion method according to the European Committee on Antimicrobial Susceptibility Testing recommendations. Results The prevalence of urinary tract infections was 29.2% (317/1086), of which 25.1% and 4.1% were mono-infections and co-infections, respectively. The prevalence of UTIs with E. coli was 28.7% (91/317) with a predominance of isolation in women. K. pneumoniae was responsible for 16.2% (61/317) of UTIs. E. coli and K. pneumoniae Uropathogenic strains showed resistance to beta-lactams, quinolones and cotrimoxazole, whereas Nitrofurantoin, Amikacin, Imipenem and Ertapenem were the most active antibiotics against E. coli and K. pneumoniae uropathogenic strains. Conclusion This study showed a high prevalence of urinary tract infections with a major implication of E.coli and K. pneumoniae strains. E. coli and K. pneumoniae presented high frequency of resistance to antibiotics, highlighting the need to adapt their use accordingly at the local level.

Identification of metallo-β-lactamases and AmpC production among Escherichia coli strains isolated from hemodialysis patients with urinary tract infection

“…This higher resistance rate could be explained by the excessive parenteral administration of these antibiotics in our region. Our study explored a high resistance rate, ranging from 72.3 to 85.1%, against TGC antibiotics, which was in agreement with previous researches conducted by Raeispour et al [ 25 ] and Lee et al [ 33 ], but in contrast to findings achieved from USA [ 24 ] and Gabon [ 30 ]. The high resistance rates against TGCs is possibly rooted in increasing the spread of extended-spectrum β-lactamase genes in UTI pathogens in Iran and other countries during recent decades, which were not investigated in the current study [ 34 , 35 ].…”

“…Of the three aminoglycosides studied here, AMK showed the highest efficacy compared to GEN and TOB, supporting previous studies from USA [ 24 ] and Gabon [ 30 ]. However, a survey by Kushwaha et al [ 31 ] from Nepal showed an opposite result: GEN had higher efficacy against UTI-inducing E .…”

“…Similarly, Raeispour et al [ 23 ] implied that 90% of UTI-inducing E. coli isolates were susceptible to this antibiotic, as well. In another study in Gabon, which was comparable with ours, Mouanga Ndzime et al [ 30 ] identified NF as the most effective drug against UTI-inducing E. coli isolates.…”

“…Likewise, a high proportion (80.9%) of E. coli isolates were susceptible to PTZ, confirming the results observed by Critchley et al [ 24 ] in the USA and Halaji et al [ 34 ] in Iran. In this study, AMP and SXT (with resistance rates of 100% and 80.9%, respectively) were among the less effective antibiotics, a result consistent with those observed in the Gabon [ 30 ], USA [ 24 ], and Iran [ 34 ].…”

“…One notable finding of this study was the relatively high prevalence of MDR (61.7%) E. coli isolates. Previous studies have reported various MDR frequencies, ranging from 55.1 to 100% for UTI-causing E. coli isolates [ 25 , 30 , 34 ]. In this study, 7 different antibiotypes were seen in MDR isolates.…”