Faecal carriage of multidrug-resistant and extended-spectrum β-lactamase-producing Enterobacterales in people living with HIV in Yaoundé, Cameroon
Brice Davy Dimani, Raspail Carrel Founou, Jessica Ravalona Zemtsa, Aurélia Mbossi, Patrice Landry Koudoum, Luria Leslie Founou, Charles Kouanfack, Lucien Honoré Etame Sone
Abstract
Antibiotic Resistance (AR) is a global health issue with multidimensional repercussions. There is a paucity of data regarding the molecular epidemiology of multidrug-resistant-Enterobacterales (MDR-E) and extended-spectrum-ß-lactamase-producing-Enterobacterales (ESBL-PE) in Africa, especially among people living with HIV (PLHIV). This study aimed at determining the prevalence, risk factors, phenotypic and genotypic profiles of MDR-E and ESBL-PE isolated from PLHIV in Yaoundé, Cameroon. In total, samples were collected from 185 PLHIV during a three-months period (April-June 2021) at the Yaounde Central Hospital. Stool samples and rectal swabs were collected and cultured on Mac Conkey agar. The API 20E kit was used for the phenotypic identification of the isolates, while antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method. The ß-lactamase genes and genotypic relatedness were studied by PCR and ERIC-PCR, respectively. The prevalence of MDR-E among PLHIV was 81%, of which 39% were ESBL-PE. A high level of resistance to fosfomycin (89%), chloramphenicol (63%), and gentamicin (56%) was observed. Escherichia coli was the predominant MDR-non-ESBL-PE (80.8%) and MDR-ESBL-PE (73.77%). The principal ß-lactamases genes in MDR-non-ESBL and MDR-ESBL-PE were blaTEM (62.90%) and blaCTX-M (40.86%), respectively. Genetic fingerprinting revealed high genetic relatedness among E. coli isolates. This study shows a high prevalence of MDR-E and ESBL-PE in the gut of PLHIV in Yaoundé, with blaTEM and blaCTX-M being the most prevalent. It demonstrates the need to strengthen real time surveillance of these resistant bacteria in order to improve management of infection among PLHIV.