Fecal Carriage of Enterobacteriaceae Producing Extended-Spectrum Beta-Lactamases in Hospitalized Patients and Healthy Community Volunteers in Burkina Faso.
Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) have been described worldwide, but few reports focused on Burkina Faso. To assess the prevalence of digestive carriage of such bacteria in the community and in the hospital, 214 fecal samples, 101 from healthy volunteers and 113 from hospitalized patients without digestive pathology, were collected in Bobo Dioulasso, Burkina Faso economic capital, during July and August 2014. Stool samples were screened using ESBL agar plates. Strains were identified by mass spectrometry using the Biotyper MALDI-TOF. ESBL production was confirmed with the double-disc synergy test. Susceptibility was tested using the disk diffusion method on Müller-Hinton agar. The main ESBL genes were detected using multiplex PCR and bidirectional gene sequencing. Escherichia coli phylogenetic groups were identified using a PCR-based method. During the study period, prevalence of subjects with fecal ESBL-PE was 32% (69/214), 22% among healthy volunteers and 42% among inpatients. All but two ESBL, CTX-M-15 and ESBL-PE, were mostly E. coli (78%). Among the 60 ESBL-producing E. coli strains, 26% belonged to phylogenetic group D, 23.3% to group A, 20% to group B1, 6.6% to group B2, and 3.3% to the ST131 clone. Univariate analysis showed that history of hospitalization and previous antibiotic use were risk factors associated with ESBL-PE fecal carriage. In Burkina Faso, the prevalence of both healthy subjects from the community and hospitalized patients with fecal ESBL-PE is alarmingly high. This feature should be taken into consideration by both general practitioners and hospital doctors with regard to empirical treatments of infections, notably urinary tract infections.
1 Centre Hospitalier Universitaire Souro Sanou , Bobo Dioulasso, Burkina Faso.|2 Centre Hospitalier Régional Universitaire (CHRU) de Montpellier , Département de Bactériologie-Virologie, Montpellier, France .|3 Université Montpellier 1 , Montpellier, France .|4 INSERM U1058, Pathogenesis and Control of Chronic Infections, Université Montpellier - EFS , Montpellier, France .
Abdoul-Salam
AS
Ouédraogo
1 Centre Hospitalier Universitaire Souro Sanou , Bobo Dioulasso, Burkina Faso.
Soufiane
S
Sanou
1 Centre Hospitalier Universitaire Souro Sanou , Bobo Dioulasso, Burkina Faso.
Aimée
A
Kissou
1 Centre Hospitalier Universitaire Souro Sanou , Bobo Dioulasso, Burkina Faso.
Armel
A
Poda
2 Centre Hospitalier Régional Universitaire (CHRU) de Montpellier , Département de Bactériologie-Virologie, Montpellier, France .|3 Université Montpellier 1 , Montpellier, France .|4 INSERM U1058, Pathogenesis and Control of Chronic Infections, Université Montpellier - EFS , Montpellier, France .
Salim
S
Aberkane
2 Centre Hospitalier Régional Universitaire (CHRU) de Montpellier , Département de Bactériologie-Virologie, Montpellier, France .|3 Université Montpellier 1 , Montpellier, France .|4 INSERM U1058, Pathogenesis and Control of Chronic Infections, Université Montpellier - EFS , Montpellier, France .
Nicolas
N
Bouzinbi
1 Centre Hospitalier Universitaire Souro Sanou , Bobo Dioulasso, Burkina Faso.
Boubacar
B
Nacro
1 Centre Hospitalier Universitaire Souro Sanou , Bobo Dioulasso, Burkina Faso.
Rasmata
R
Ouédraogo
2 Centre Hospitalier Régional Universitaire (CHRU) de Montpellier , Département de Bactériologie-Virologie, Montpellier, France .|3 Université Montpellier 1 , Montpellier, France .|4 INSERM U1058, Pathogenesis and Control of Chronic Infections, Université Montpellier - EFS , Montpellier, France .
Philippe
P
Van De Perre
2 Centre Hospitalier Régional Universitaire (CHRU) de Montpellier , Département de Bactériologie-Virologie, Montpellier, France .|3 Université Montpellier 1 , Montpellier, France .|4 INSERM U1058, Pathogenesis and Control of Chronic Infections, Université Montpellier - EFS , Montpellier, France .
Christian
C
Carriere
5 Sorbonne University , UPMC Université Paris 06 CR7, CIMI, Team E13 (Bacteriology), Paris, France .|6 INSERM U1135 , CIMI, Team E13, Paris, France .|7 AP-HP, Microbiology, St-Antoine Hospital , Paris, France .
Dominique
D
Decré
2 Centre Hospitalier Régional Universitaire (CHRU) de Montpellier , Département de Bactériologie-Virologie, Montpellier, France .
Hélène
H
Jean-Pierre
2 Centre Hospitalier Régional Universitaire (CHRU) de Montpellier , Département de Bactériologie-Virologie, Montpellier, France .|3 Université Montpellier 1 , Montpellier, France .|4 INSERM U1058, Pathogenesis and Control of Chronic Infections, Université Montpellier - EFS , Montpellier, France .
Sylvain
S
Godreuil
D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002050:Burkina Faso; D016022:Case-Control Studies; D016972:Enterobacter cloacae / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000382:microbiology; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D024841:Fluoroquinolones / Q000494:pharmacology; D015870:Gene Expression; D006760:Hospitalization; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D008297:Male; D060885:Multiplex Polymerase Chain Reaction; D010802:Phylogeny; D018440:beta-Lactam Resistance / Q000235:genetics*; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism; D047090:beta-Lactams / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D047090:beta-Lactams; D001618:beta-Lactamases
ESBL; Enterobacteriaceae; antibiotics; enzymes; genes; molecular characterization