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High ESBL-E colonization rate among children in Gabon: a follow-up study
Journal of Medical Microbiology ( IF 3 ) Pub Date : 2021-08-18 , DOI: 10.1099/jmm.0.001405
Philipp Hofmann 1, 2 , Abraham Alabi 3 , Gédéon P Manouana 2, 4 , Francis C Onwugamba 5 , Amelia Hasenauer 6 , Maradona D Agbanrin 4 , Christiane S M Gouleu 4 , Gédéon Bingoulou 4, 7 , Steffen Borrmann 2, 4 , Matthew B B McCall 2, 4, 8 , Ayola A Adegnika 2, 4, 9
Affiliation  

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, bla CTX-M, bla SHV, and bla TEM, 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 (n=293) were susceptible to meropenem and bla CTX-M 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.

中文翻译:

加蓬儿童 ESBL-E 高定植率:一项后续研究

先前于 2010/11 年在中非加蓬进行的一项研究发现,产超广谱 β-内酰胺酶肠杆菌 (ESBL-E) 的儿童定植率高达 34%。八年后,我们旨在重新评估 ESBL-E 率和先前确定的加蓬儿童定植的风险因素。我们于 2018 年对加蓬兰巴雷内的 92 名 5 岁以下腹泻门诊患者进行了横断面队列研究,他们在初次就诊时(基线)采集了直肠拭子。其中 58 个在 1 周后提供了进一步的直肠拭子。评估 ESBL-E 定植 [按照欧洲抗微生物药敏试验委员会 (EUCAST)],在确认的 ESBL-E 分离株中,对美罗培南的敏感性和最丰富的 ESBL 基因的流行,bla CTX-Mbla SHVbla TEM进行了研究。在基线时,ESBL-E 定植率为 57% (52/92;95% CI:46-67)。前一年住院、过去一周的鸡肉消费和年轻被确定为基线时 ESBL-E 定植的独立危险因素。在第 7 天,ESBL-E 携带率为 72%(42/58;95% CI:59-83)。所有 ESBL-E 分离株 ( n = 293) 对美罗培南和bla CTX-M敏感是最常检测到的β-内酰胺酶基因。加蓬儿童的 ESBL-E 定植率高得惊人,近年来有进一步增加的迹象。虽然所有 ESBL-E 菌株目前仍对美罗培南敏感,但实际上,对于此类分离株的严重感染,当地没有足够的治疗方法。因此,投资改进医院感染预防和控制措施以有效对抗 ESBL-E 至关重要。
更新日期:2021-08-19
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