Faecal carriage of multidrug-resistant and extended-spectrum β-lactamase-producing Enterobacterales in people living with HIV in Yaoundé, Cameroon

Objectives: 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 Yaounde, Cameroon.Methods: In total, samples were collected from 185 PLHIV during a three-month 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, whereas 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.Results: The prevalence of MDR-E among PLHIV was 81%, of which 39% were ESBL-PE. A high level of re-sistance 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. Ge-netic fingerprinting revealed high genetic relatedness among E. coli isolates.Conclusion: This study shows a high prevalence of MDR-E and ESBL-PE in the gut of PLHIV in Yaounde, 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.(c) 2023 The Author(s). Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )

Automated summary

This study reveals the prevalence and resistance characteristics of multidrug-resistant Enterobacterales (MDR-E) and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) in the gut of people living with HIV in Yaounde, Cameroon. The study highlights the need for real-time surveillance of these resistant bacteria to improve infection management among people living with HIV.