AUTHOR=Djim-Adjim-Ngana Karyom , Mbiakop Brunel W. , Oumar Leila A. , Munshili Njifon Hermann L. , Tchinda Fossi Cedric , Enyegue Elisee L. Embolo , Mouiche Mouliom Mohamed M. , Fodouop Chegaing Siméon P. , Deweerdt Louis , Yanou Nicolas Njintang , Nguinkal Julien A. 

TITLE=Phenotypic characterization and epidemiology of extended-spectrum β-lactamase-producing Enterobacteriaceae strains from urinary tract infections in Garoua, Cameroon

JOURNAL=Frontiers in Public Health

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1187934

DOI=10.3389/fpubh.2023.1187934

ISSN=2296-2565

ABSTRACT=The emergence of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) is a growing concern worldwide, leading to increased morbidity and mortality because of therapeutic failures. ESBL-E are priority pathogens due to their multidrug resistance (MDR). In Northern Cameroon, ESBL-producing bacteria are increasingly being isolated from clinical samples, particularly in urinary tract infections (UTIs). This study aimed to determine the prevalence of multi-drug resistant ESBL strains isolated from UTIs in 2017 in Northern Cameroon and to evaluate the effectiveness of the ATB UR Gallery of BioMérieux in diagnosing ESBL-E in clinical settings. We utilized standard microbiology protocols and statistical tools to identify ESBL-producing bacteria, characterize their phenotypic suceptiblity and resistance profiles in the study population. Out of the 144 enterobacteria isolates successfully cultured, 59 (41%) were MDR strains. The ATB UR EU gallery identified 33 (23%) multi-drug resistant ESBL-producing strains, while the double synergy test identified 35 without disc reconciliation and 38 after reconciliation. The most common ESBL-E was Escherichia coli, accounting for 77.1% of the isolates, followed by Klebsiella pneumonia (20%) and \textit{Enterobacter aerogenes} (2.9%). In addition, our study revealed the emergence of Imipenem resistance (5.7%), a critical last-resort antibiotic. However, all ESBL strains were sensitive to Fosfomycin (FSF/FOS), showing its potential as an effective therapeutic option. Moreover, 37% of the ESBL producers showed co-resistance to over 20 different antibiotics. This study provide additional insights into the prevalence and susceptibility patterns of ESBL-E associated with UTIs in the country. These insights are critical for developing appropriate treatment guidelines and antimicrobial stewardship measures to mitigate the spread and impact of MDR ESBL-producing strains on public health.