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 Yaoundé, Cameroon.

METHODS

In total, samples were collected from 185 PLHIV during a three-month period (April-June 2021) at the Yaoundé Central Hospital. Stool samples and rectal swabs were collected and cultured on MacConkey 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 resistance 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. Genetic 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 Yaoundé, 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.

Prevalence and Identification of Serum Markers Associated with Vertical Transmission of Hepatitis B in Pregnant Women in Yaounde, Cameroon

OBJECTIVE

To determine the prevalence of Hepatitis B Virus (HBV) infection in pregnant women and identify markers associated with vertical transmission of HBV.

METHODS

Prospective and cross-sectional study over 10 months on 298 pregnant women attending antenatal clinics in the Cité Verte and Efoulan District hospitals in Cameroon. A dry tube blood collection was performed on all pregnant women and babies born to HBsAg-positive mothers. Serum from the women was used to test for HBsAg through immunochromatography and then confirmed by ELISA. The test for HBeAg, HBeAb and HBcAb and dosage of transaminases were performed on the serum of HBsAg-positive women. Only HBsAg was tested in babies within 24 hours after birth.

RESULTS

HBsAg was present in 23 (7.7%) mothers while 275 (92.3%) tested negative. Due to loss to follow-up, we assessed vertical transmission in 20 babies born to20 mothers. In all, eight babies tested HBsAg-positive; six mothers tested positive with HBeAg; 10 mothers with HBeAb and two were simultaneously infected with HBV and HIV.

CONCLUSION AND GLOBAL HEALTH IMPLICATIONS

HBeAg and increase in liver transaminases were serum markers associated with the vertical transmission of HBV while HBeAb and anti-HIV therapy were protective markers. There is need to systematically screen all pregnant women for hepatitis B, follow up those that are positive, and administer a dose of gammaglobulin anti-HBs to their children to reduce the risks of chronic hepatitis and hepatocellular carcinoma (CHC) and curb mortality and morbidity due to viral hepatitis B.