Maternal and Neonatal Colonization with Multidrug Resistant and Extended Spectrum ß-Lactamase ProducingEscherichia coliandKlebsiella pneumoniaein a Cameroonian Labour Ward

Abstract

Background: Escherichia coli and Klebsiella pneumoniae rank among the primary bacterial culprits in neonatal infections and fatalities in sub-Saharan Africa. This study sought to characterize the phenotypic and genotypic features of Escherichia coli and Klebsiella pneumoniae in a labour ward in Yaounde, Cameroon. Methods: A prospective and cross-sectional study spanning five months, from February 21 to June 30, 2022. Recto-vaginal swabs were obtained from expectant mothers, and nasopharyngeal swabs were collected from their babies. The samples were cultured on eosin methylene blue agar and isolates identified using the Enterosystem 18R kit. Extended-spectrum beta-lactamase (ESBL) production was assessed using CHROMAgar ESBL and the double disc synergy test. Antibiotic susceptibility was determined by the Kirby-Bauer disk diffusion method. Polymerase chain reaction (PCR) was employed to detect beta-lactamase genes blaSHV, blaCTX-M and blaTEM. ERIC-PCR was used to assess the clonal relatedness of isolates. Results: E. coli was predominantly found in pregnant women (81%) and neonates (55%) while K. pneumoniae predominated in healthcare workers. Almost all pregnant women (90%) were colonized by one or more multi-drug resistant (MDR) isolates with 52% being concomitantly ESBL producers. Altogether, 22 neonates were positive for E. coli and/or K. pneumoniae and 19 (91%) were colonized by a MDR isolate. The blaCTX-M (75%) was the leading beta-lactamase gene detected. Conclusion: Our study suggests that MDR- and ESBL-E. coli and K. pneumoniae are circulating at high prevalence in labour Yaounde. It emphasizes the necessity for strict infection prevention and control measures in conjunction with effective antimicrobial stewardship in the country.