%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Mahamat, O. O.
%A Lounnas, Manon
%A Hide, M.
%A Dumont, Y.
%A Tidjani, A.
%A Kamougam, K.
%A Abderrahmane, M.
%A Benavides, J.
%A Solassol, J.
%A Banuls, Anne-Laure
%A Jean-Pierre, H.
%A Carriere, C.
%A Godreuil, S.
%T High prevalence and characterization of extended-spectrum ss-lactamase producing Enterobacteriaceae in Chadian hospitals
%D 2019
%L fdi:010075263
%G ENG
%J BMC Infectious Diseases
%@ 1471-2334
%K ESBL ; Enterobacteriaceae ; Clinical samples ; Prevalence ; Chad
%K TCHAD
%M ISI:000460031100005
%P art. 205 [7 ]
%R 10.1186/s12879-019-3838-1
%U https://www.documentation.ird.fr/hor/fdi:010075263
%> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers19-03/010075263.pdf
%V 19
%W Horizon (IRD)
%X BackgroundExtended-spectrum ss-lactamase-producing Enterobacteriaceae (ESBL-PE) represent a major problem in the management of nosocomial infections. However, ESBL-PE are not systematically monitored in African countries. The aim of this study was to determine ESBL-PE prevalence in patients from three hospitals in N'Djamena, the capital city of Chad, and to characterize the genetic origin of the observed resistance.MethodsFrom January to March 2017, 313 non-duplicate isolates were recovered from various clinical specimens obtained from 1713 patients in the three main hospitals of N'Djamena. Bacterial species were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Susceptibility to 28 antibiotics was tested using the disk diffusion method on Muller-Hinton agar, and ESBL production was confirmed with the double-disc synergy test. The most prevalent ESBL genes associated with the observed resistance were detected using multiplex PCR followed by double-stranded DNA sequencing.ResultsAmong the 313 isolates, 197 belonged to the Enterobacteriaceae family. The overall ESBL-PE prevalence was 47.72% (n=94/197), with a higher rate among inpatients compared with outpatients (54.13% vs. 34.37%). ESBL-PE prevalence was highest in older patients (60years of age). E. coli was the most common ESBL-producer organism (63.8%), followed by K. pneumoniae (21.2%). ESBL-PE were mainly found in urine samples (75%). The CTX-M-1 group was dominant (96.7% of the 94 ESBL-PE isolates, CTX-M-15 enzyme), followed by the CTX-M-9 group (4.1%). 86% of resistant isolates harbored more than one ESBL-encoding gene. ESBL production was also associated with the highest levels of resistance to non--lactam drugs.ConclusionsThe prevalence of ESBL-PE harboring resistant genes encoding ESBLs of the CTX-M-1 group was high (48%) among clinical isolates of three main hospitals in Chad, suggesting an alarming spread of ESBL-PE among patients.
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