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Volume 70, Issue 8

High ESBL-E colonization rate among children in Gabon: a follow-up study No Access

Abstract

A previous study conducted in Gabon, Central Africa, in 2010/11 found a high colonization rate with extended-spectrum β-lactamase-producing enterobacterales (ESBL-E) among children of ~34 %. Eight years later, we aimed to reassess the ESBL-E rate and previously identified risk factors for colonization in children from Gabon. We conducted a cross-sectional cohort study in 2018 on 92 outpatients under 5 years of age with diarrhoea in Lambaréné, Gabon, in whom a rectal swab was obtained at the initial medical encounter (baseline). Fifty-eight of these provided a further rectal swab 1 week afterwards. ESBL-E colonization was assessed [following the European Committee on Antimicrobial Susceptibility Testing (EUCAST)], and in confirmed ESBL-E isolates the susceptibility to meropenem and the prevalence of the most abundant ESBL genes, , , and , were investigated. At baseline, the ESBL-E colonization rate was 57 % (52/92; 95 % CI: 46–67). Hospitalization during the previous year, chicken consumption in the past week and young age were identified as independent risk factors for ESBL-E colonization at baseline. On day 7, the ESBL-E carriage rate was 72 % (42/58; 95 % CI: 59–83). All ESBL-E isolates (=293) were susceptible to meropenem and was the most frequently detected β-lactamase gene. The ESBL-E colonization rate among children from Gabon is alarmingly high, with indications of further increase over recent years. While all ESBL-E strains remain currently susceptible to meropenem, in practice no adequate treatment is available locally for severe infections with such isolates. It is thus of the utmost importance to invest in improved hospital infection prevention and control measures to combat ESBL-E effectively.

  • Received:
  • Accepted:
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Keyword(s): Africa , colonization , ESBL-E , hospital hygiene and risk factors
Funding
This study was supported by the:
  • Deutsche Forschungsgemeinschaft (Award GZ EI 1044/1-1)
    • Principle Award Recipient: NotApplicable
© 2021 The Authors
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/content/journal/jmm/10.1099/jmm.0.001405
2021-08-17
2024-04-25
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High ESBL-E colonization rate among children in Gabon: a follow-up study
J. Med. Microbiol. 70, 001405 (2021); https://doi.org/10.1099/jmm.0.001405
/content/journal/jmm/10.1099/jmm.0.001405
/content/journal/jmm/10.1099/jmm.0.001405
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