High Fecal Carriage of Extended-Spectrum β-Lactamase Producing Enterobacteriaceae by Children Admitted at the Pediatric University Hospital Complex in Bangui, Central African Republic

Background: Antimicrobial resistance (AMR) has become a global public health threat. Quality data on AMR are needed to tackle the rise of multidrug resistant clones globally. These data are rare in low-and-middle-income countries, especially in sub-Saharan Africa. In this study, we aimed to investigate on the rise of extended-spectrum β-lactamase-producing (ESBL) enterobacteriaceae in Bangui, Central African Republic.<br><br>Methods: We collected 278 fecal samples from 0-5 year-old children admitted at the Pediatric University Hospital Complex in Bangui, from July to September 2021. Bacteria were isolated on BCP and CHROMagar ESBL plates, and identified using API&nbsp;galleries. Susceptibility to 19 antibiotics belonging to seven classes was tested using disc diffusion method and interpreted according to EUCAST 2021 guidelines.<br><br>Results: We isolated one and two enterobacteriaceae species from 208 and 29 samples respectively, for a total of 266 strains. Escherichia coli predominated followed by Klebsiella . AMR was frequent with 98.5% (262/266) of the isolates resistant to one antibiotic at least. Of these isolates, 89.5% (238/266) were multidrug resistant, resistance being frequent against all the tested classes except carbapenems and tigecycline for which no resistance was found. Importantly, 71.2% of the children carried at least one ESBL species and 85.3% (227/266) of the isolates displayed this phenotype.<br><br>Conclusion: This study confirms the rise of ESBL enterobacteriaceae in Bangui and stresses the need of an active surveillance and to monitor the use of antimicrobials in both hospital and community settings in order to preserve the efficacy of antibiotics crucial for treatment of bacterial infections.