African Journal of
Microbiology Research

  • Abbreviation: Afr. J. Microbiol. Res.
  • Language: English
  • ISSN: 1996-0808
  • DOI: 10.5897/AJMR
  • Start Year: 2007
  • Published Articles: 4816

Full Length Research Paper

Extended-spectrum beta-lactamase- and carbapenemase-producing Enterobacteriaceae clinical isolates in a Senegalese teaching hospital: A cross sectional study

Makhtar Camara
  • Makhtar Camara
  • Laboratoire de Bactériologie-Virologie, Centre Hospitalier National Universitaire (CHNU) Aristide Le Dantec, Dakar, Sénégal.
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Mamadou Thierry Mane
  • Mamadou Thierry Mane
  • Laboratoire de Bactériologie-Virologie, Centre Hospitalier National Universitaire (CHNU) Aristide Le Dantec, Dakar, Sénégal.
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Awa Ba-Diallo
  • Awa Ba-Diallo
  • Laboratoire de Bactériologie-Virologie, Centre Hospitalier National Universitaire (CHNU) Aristide Le Dantec, Dakar, Sénégal.
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Assane Dieng
  • Assane Dieng
  • Laboratoire de Bactériologie-Virologie, Centre Hospitalier National Universitaire (CHNU) Aristide Le Dantec, Dakar, Sénégal.
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Halimatou Diop-Ndiaye
  • Halimatou Diop-Ndiaye
  • Laboratoire de Bactériologie-Virologie, Centre Hospitalier National Universitaire (CHNU) Aristide Le Dantec, Dakar, Sénégal.
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Farba Karam
  • Farba Karam
  • Laboratoire de Bactériologie-Virologie, Centre Hospitalier National Universitaire (CHNU) Aristide Le Dantec, Dakar, Sénégal.
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Seynabou Lo-Lo
  • Seynabou Lo-Lo
  • URF des Sciences de la Santé, Université Gaston Berger, Saint Louis, Sénégal.
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Habsa Diagne-Samb
  • Habsa Diagne-Samb
  • Laboratoire de Bactériologie-Virologie, Centre Hospitalier National Universitaire (CHNU) Aristide Le Dantec, Dakar, Sénégal.
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Safietou Ngom-Cisse
  • Safietou Ngom-Cisse
  • Laboratoire de Bactériologie-Virologie, Centre Hospitalier National Universitaire (CHNU) Aristide Le Dantec, Dakar, Sénégal.
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Coumba Toure-Kane
  • Coumba Toure-Kane
  • Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formation (IRESSEF), Dakar, Sénégal.
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Aïssatou Gaye-Diallo
  • Aïssatou Gaye-Diallo
  • Laboratoire de Bactériologie-Virologie, Centre Hospitalier National Universitaire (CHNU) Aristide Le Dantec, Dakar, Sénégal.
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Souleymane Mboup
  • Souleymane Mboup
  • Laboratoire de Bactériologie-Virologie, Centre Hospitalier National Universitaire (CHNU) Aristide Le Dantec, Dakar, Sénégal.
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Cheikh Saad Bouh Boye
  • Cheikh Saad Bouh Boye
  • Laboratoire de Bactériologie-Virologie, Centre Hospitalier National Universitaire (CHNU) Aristide Le Dantec, Dakar, Sénégal.
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  •  Received: 23 September 2017
  •  Accepted: 13 November 2017
  •  Published: 28 November 2017

Abstract

Extended spectrum β-lactamase (ESBL) and carbapenemase-producing Enterobacteriaceae (CPE) have been increasingly reported worldwide. The objective of this study is to determine the prevalence of these multidrug-resistant strains in a major university teaching hospital in Dakar, Senegal. A total of 1205 Enterobacteriaceae stains were tested for ESBL and carbapenemase production. Antibiotics susceptibility test was performed with disk diffusion method. ESBL was detected using a double-disk synergy method. Carbapenemase production was detected with ertapenem 10 µg disk charge. The overall prevalence of ESBL- and carbapenemase-producing Enterobacteriaceae was 26.2 (316/1205) and 5.1% (62/1205), respectively. Interestingly, 3.8% of these pathogens were both ESBL-carbapenemase producers. Among the Enterobacteriaceae ESBL positive, Escherichia coli (45.2%, 143/316), Klebsiella pneumoniae (26.3%, 83/316), Enterobacter cloacae (12.7%, 40/316), and Proteus vulgaris (9.2%, 29/316) were the most prevalent. These strains were mainly isolated from urine (56.6%) and pus (22.7%) specimen. The most prevalent CPEs were E. coli (45.2%, 28/62), K. pneumoniae (27.4%, 17/62), and E. cloacae (16.1%, 10/62), particularly isolated from urine (58%) and pus (19.3%). The majority of these MDR strains were isolated from patients hospitalized in urology (32.4%), surgery (27.7%), internal medicine (18.5%), and intensive care units (10%). ESBL-producing Enterobacteriaceae remain highly susceptible to fosfomycin (94.1%), amikacin (92.5%) and ertapenem (88.6%), while carbapenemase producers were fully susceptible to amikacin (100%), and to a lesser extent, fosfomycin (66.7%) and colistin (60%). This study revealed increasing prevalence of ESBL- and carbapenemase-producing Enterobacteriaceae with limited therapeutic options, suggesting a need for continuous multi-drug resistant (MDR) surveillance patterns particularly in hospital settings.

Key words: Extended spectrum β-lactamase, carbapenemase, Enterobacteriaceae.