Prevalence of CTX-M beta-Lactamases in Escherichia coli from community-acquired urinary tract infections and associated risk factors among women in Cameroon

Abstract

Background: In recent years, a worldwide dissemination of CTX-M beta-lactamase-type in Escherichia coli strains isolates from community-acquired urinary tract infections (CA-UTI) has been observed. However little is known on the prevalence and risk factors of this global threat in developing countries. Objective: The aim of this study was to study the prevalence and risk factors for CA-UTI in Yaoundé, Cameroon. Methods: Eighty six patients with urinary E.coli infection recruited from 10 health structures in the town of Yaoundé, Cameroon. After taking the first urine, faeces were collected from the patients for the study of the intestinal flora. The sample collection of faeces was done on a selected gel of enterobacteria resistant to third generation of cephalosporin. The molecular typing of extended-spectrum β-lactamase (ESBL) was carried out. Results: Eighty-six strains of E. coli from 86 patients were included. We found that 39 (45.3%) strains produced an extendedspectrum beta-lactamase. Among risk factors, previous use of antibiotic and the dry season were associated with the presence of an ESBL-producing strain in the urine. All ESBL were identified as CTX-M. The production of CTX-M was found to be significantly associated with resistance to fluoroquinolones, aminoglycosides and to the association of trimethoprim-sulfamethazole. Conclusions: The prevalence of CTX-M ESBL in Yaoundé, Cameroon, provides new evidence on the global dissemination of CTX-M and the extent of this phenomenon in developing countries.

Antimicrobial susceptibility patterns and CTX-M β-lactamase producing clinical isolates from burn patients in Islamabad, Pakistan

“…Similar finding has already been reported that all strains of E. coli had CTX-M gene [21]. It has also been documented that clinical isolates of E. coli and Klebsiella spp.…”

“…Moreover, the period of hospitalization, hygienic conditions and drinking water quality also propagate MDR microbes as it has been reported that short-time stay of burn patients in hospital (7 days) led to 10% colonization of microbes while longtime stay (50 days) increased colonization up to 90% [35]. Another study reported that poor hygienic conditions such as contaminated drinking water promote Enterobacteriaceae strains circulation leading to MDR [21].…”

“…It has also been documented that clinical isolates of E. coli and Klebsiella spp. are resistant to many antibiotics such as aminoglycosides, cotrimoxazole and ciprofloxacin, but none of the resistance was displayed to carbapenem [21,36], which was generated due to CTX-M enzyme production. Piperacillin-tazobactam antibiotics combination exhibited even more susceptibility against CTX-M-producing isolates.…”

“…Hence, skin damage along with compromised blood supply around wound and immunodeficiency increase acquisition of nosocomial infection in burn patients [1,7-resistant strains thus limiting therapeutic options [3,13,[16][17][18][19]. The primary cause for production of multiple drug resistant strains is β-lactamases particularly extended spectrum β-lactamases (ESBL) whose incidence is steadily increasing all over the world [9,16,[19][20][21][22][23][24]. Most prevalent types of ESBL are TEM (TEM1-2), SHV-1 and CTX-M which are produced by Gram negative bacilli.…”

Antibiotic Susceptibility and Molecular Characterization of Escherichia coli O157 Isolates from Urinary Tract Infections

“…In our study, more than half of urine samples were positive to E. coli and 23 E. coli O157 isolates were obtained. Previous studies conducted in various parts of the world showed that the prevalence rate of E. coli O157 was about 10% [21,22]. In this study, the contamination rates were only approximate values.…”