Contributors: Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC); Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud]); Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier); Hôpital de la Mère et de l’Enfant [N’Djaména, Tchad]; Du gène à l'écosystème (MIVEGEC-GeneSys); Pathogènes, Environnement, Santé Humaine (EPATH); Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC); Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud]); Université de N'Djaména; Hôpital Général des Références Nationale [N'Djamena, Tchad] (HGRN); L’hôpital de la Renaissance [D'Jamena, Tchad]; Universidad Andrés Bello [Santiago] (UNAB); Pôle Biologie-Pathologie [CHRU Montpellier]; Laboratoire Mixte International Drug Resistance in Southeast Asia (LMI DRISA); Institut Pasteur du Cambodge; Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Oxford University Clinical Research Unit [Ho Chi Minh City] (OUCRU)-Fondation Mérieux-University of sciences and technologies of hanoi (USTH)-Center of Infectiology Lao-Christophe Mérieux [Vientiane] (CILM); This study was supported by a grant from Islamic Development Bank (IDB).; We would like to thank IRD and CHU. We thank Elisabetta Andermarcher for assistance in preparing and editing the manuscript.; Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Oxford University Clinical Research Unit [Ho Chi Minh City] (OUCRU)-Fondation Mérieux-University of Science and Technology of Hanoi (USTH)-Center of Infectiology Lao-Christophe Mérieux [Vientiane] (CILM); Fondation Mérieux-Center of Infectiology Lao-Christophe Mérieux [Vientiane] (CILM)-Institut Pasteur du Cambodge; Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-University of sciences and technologies of hanoi (USTH)-Oxford University Clinical Research Unit [Ho Chi Minh City] (OUCRU)
نبذة مختصرة : Background Extended-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. Methods From 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 Müller-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. Results Among 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 (≥60 years 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-β-lactam drugs. Conclusions The 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. Electronic supplementary material The online version of this article (10.1186/s12879-019-3838-1) contains supplementary material, which is available to authorized users.
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