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Abstract

INCREASED RATE OF EXTENDED-SPECTRUM BETA-LACTAMASE (ESBL)-PRODUCING INTESTINAL Enterobacteriaceae AMONG HOSPITALIZED PATIENTS IN THE SURGICAL DEPARTMENTS OF THREE HEALTH FACILITIES IN THE NDE DIVISION, WEST-CAMEROON

William Lelorel Nankam Nguekap, Pierre René Fotsing Kwetche*, Gildas Boris Tazemda-Kuitsouc, Golda Joyce Chouna Djeutsa, Anicette Chafa, Yawat Djogang Anselme Michel, Michel Simonet and Jean Michel Tekam

ABSTRACT

The increasing rates of therapeutic failure imposed by resistance to antibacterial agents has become a global health challenge endowed with community specificities. One of the most common traits in bacteria is related to the expression of extended spectrum betalactamases (ESBL), a large group of determinants that inhibit ranges of β-lactam’s antibiotics and represent serious threats to public health. The present study aimed at investigating the influence of hospitalization in the overall bacterial susceptibility and more specifically, the interplay between hospital stay and ESBL rates within the surgery departments of three health facilities in West Cameroon. When all administrative and ethical requirements were met, rectal swabs (or stools) were collected for bacterial screening and Susceptibility testing. Prior to specimen collection, a record was made on drug administration during hospital stay for each respondent. All laboratory procedures were conducted according to standard protocols (CAS-SFM 2019; REMIC; 2018) with focus on Enterobacteriaceae. Data analyses revealed that beta-lactams were commonly used. A total of 104 specimens were collected from which 241 isolates were recovered (131 recovered on admission and 110 at discharge). Most common isolates were E. coli, Proteus spp., and Klebsiella spp. Susceptibility tests indicated higher resistance rates at discharge than on admission, with significant difference observed with β-lactams, unlike fluoroquinolones and aminoglycosides. Moreover, the detection rates of ESBL were significantly higher at discharge and was found to be strongly associated with hospitalization. Altogether, these results represented reliable indicators of a break between stakeholders in the caretaking chain. They therefore, highlighted the need to promote policies aiming at increasing the turn-over in order to reduce the risk of colonization by multidrug-resistant bacteria during hospitalization. Trained and committed human resources were thought to be primordial in designing and implementing sustainably, health policies that could meet current and future challenges related to antibacterial resistance.

Keywords: Hospitalization, ESBL, surgery patients, West-Cameroon.


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