OBJECTIVES: Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) are sporadically reported from infections in sub-Saharan Africa. Travellers returning from the tropics have a high risk of ESBL-E colonization, which suggests a high prevalence of ESBL-E in Africa. Our objective was to assess the burden of rectal ESBL-E colonization and associated risk factors in Gabon, Central Africa PATIENTS AND METHODS: We performed a cross-sectional study on 200 hospitalized children in Gabon, Central Africa, on rectal ESBL-E colonization and applied a standardized questionnaire to assess risk factors. The antimicrobial resistance and the type of β-lactamase (SHV, TEM and CTX-M) were analysed for each isolate. Isolates associated with nosocomial spread were further genotyped. RESULTS: The overall colonization rate of ESBL-E was 45% (n = 90) and increased from 33.6% (n = 37) at admission to 94.1% (n = 16) during hospitalization. Risk factors for ESBL-E carriage were age <5 years, hospitalization for ≥5 days and a hospital stay during the past year. All isolates were susceptible to meropenem, but non-susceptible to ciprofloxacin in 52.8% (n = 57). CTX-M-15 was the predominant β-lactamase. Genotyping revealed a polyclonal structure of nosocomial isolates. CONCLUSIONS: ESBL colonization in hospitalized children in Gabon is high. The risk of nosocomial transmission of ESBL-E is a challenge in rural Africa and underlines the need for sentinel surveillance in the absence of a broad decentralized microbiology laboratory.
OBJECTIVES: Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) are sporadically reported from infections in sub-Saharan Africa. Travellers returning from the tropics have a high risk of ESBL-E colonization, which suggests a high prevalence of ESBL-E in Africa. Our objective was to assess the burden of rectal ESBL-E colonization and associated risk factors in Gabon, Central Africa PATIENTS AND METHODS: We performed a cross-sectional study on 200 hospitalized children in Gabon, Central Africa, on rectal ESBL-E colonization and applied a standardized questionnaire to assess risk factors. The antimicrobial resistance and the type of β-lactamase (SHV, TEM and CTX-M) were analysed for each isolate. Isolates associated with nosocomial spread were further genotyped. RESULTS: The overall colonization rate of ESBL-E was 45% (n = 90) and increased from 33.6% (n = 37) at admission to 94.1% (n = 16) during hospitalization. Risk factors for ESBL-E carriage were age <5 years, hospitalization for ≥5 days and a hospital stay during the past year. All isolates were susceptible to meropenem, but non-susceptible to ciprofloxacin in 52.8% (n = 57). CTX-M-15 was the predominant β-lactamase. Genotyping revealed a polyclonal structure of nosocomial isolates. CONCLUSIONS: ESBL colonization in hospitalized children in Gabon is high. The risk of nosocomial transmission of ESBL-E is a challenge in rural Africa and underlines the need for sentinel surveillance in the absence of a broad decentralized microbiology laboratory.
Authors: Michael Preziosi; Tomas Francisco Zimba; Kristen Lee; Manuel Tomas; Suraida Kinlin; Clotilde Nhatave-Paiva; Rosa Bene; Tania Paunde; Helder Lopes; Stephen Kalkhoff; Vishnu Prathap; Kevan Akrami; Emilia Virginia Noormahomed; Robert Turner Schooley; Eliah Aronoff-Spencer Journal: S Afr Med J Date: 2015-04-08
Authors: Frieder Schaumburg; Abraham S Alabi; Lisa Frielinghaus; Martin P Grobusch; Robin Köck; Karsten Becker; Saadou Issifou; Peter G Kremsner; Georg Peters; Alexander Mellmann Journal: BMC Microbiol Date: 2014-11-19 Impact factor: 3.605
Authors: Abraham S Alabi; Lisa Frielinghaus; Harry Kaba; Katrin Kösters; Michaëla A M Huson; Barbara C Kahl; Georg Peters; Martin P Grobusch; Saadou Issifou; Peter G Kremsner; Frieder Schaumburg Journal: BMC Infect Dis Date: 2013-10-02 Impact factor: 3.090
Authors: Tolbert Sonda; Happiness Kumburu; Marco van Zwetselaar; Michael Alifrangis; Ole Lund; Gibson Kibiki; Frank M Aarestrup Journal: Antimicrob Resist Infect Control Date: 2016-05-14 Impact factor: 4.887