High third-generation cephalosporin resistant Enterobacteriaceae prevalence rate among neonatal infections in Dakar, Senegal

Sebastien Breurec (1, 2) , Coralie Bouchiat (3) , Jean-Marie Sire (3) , Olivier Moquet (3) , Raymond Bercion (3, 4) , Moussa Fafa Cisse (5) , Philippe Glaser (6) , Ousmane Ndiaye (7) , Sidy Ka (8) , Helene Salord (9) , Abdoulaye Seck (3) , Haby Signate Sy (10) , Remy Michel (11) , Benoit Garin (3)

1 Institut Pasteur de la Guadeloupe
2 UAG - Université des Antilles et de la Guyane
3 Institut Pasteur de Dakar
4 Institut Pasteur de Bangui
5 Hôpital des Enfants Albert Royer, Laboratoire de Bactériologie
6 Biologie des Bactéries Pathogènes à Gram-positif
7 UCAD - Université Cheikh Anta Diop de Dakar [Sénégal]
8 Département de Pédiatrie
9 Laboratoire de Microbiologie Croix-Rousse
10 Département de Pédiatrie
11 Unité d’Epidémiologie

Background: Neonatal infection constitutes one of Senegal’s most important public health problems, with a mortality rate of 41 deaths per 1,000 live births. Methods: Between January 2007 and March 2008, 242 neonates with suspected infection were recruited at three neonatal intensive care units in three major tertiary care centers in Dakar, the capital of Senegal. Neonatal infections were confirmed by positive bacterial blood or cerebrospinal fluid culture. The microbiological pattern of neonatal infections and the antibiotic susceptibility of the isolates were characterized. In addition, the genetic basis for antibiotic resistance and the genetic background of third-generation cephalosporin-resistant (3GC-R) Enterobacteriaceae were studied. Results: A bacteriological infection was confirmed in 36.4 % (88/242) of neonates: 22.7 % (30/132) during the early-onset and 52.7 % (58/110) during the late-onset periods (p > 0.20). Group B streptococci accounted for 6.8 % of the 88 collected bacterial isolates, while most of them were Enterobacteriaceae (n = 69, 78.4 %). Of these, 55/69 (79.7 %) were 3GC-R. The blaCTX-M-15 allele, the blaSHV and the blaTEM were highly prevalent (63.5, 65.4 and 53.8 %, respectively), usually associated with qnr genes (65.4 %). Clonally related strains of 3GC-R Klebsiella pneumoniae and 3GC-R Enterobacter cloacae, the two most commonly recovered 3GC-R Enterobacteriaceae (48/55), were detected at the three hospitals, underlining the role of cross-transmission in their spread. The overall case fatality rate was 18.6 %. Conclusions: Measures should be taken to prevent nosocomial infections and the selection of resistant bacteria

Mots clés: Africa; CTX-M-15; Third-generation cephalosporin-resistant Enterobacteriaceae; Neonatal infections; Antimicrobial resistance

Domaines: Maladies infectieuses; Bactériologie

Sebastien Breurec, Coralie Bouchiat, Jean-Marie Sire, Olivier Moquet, Raymond Bercion, et al.. High third-generation cephalosporin resistant Enterobacteriaceae prevalence rate among neonatal infections in Dakar, Senegal. BMC Infectious Diseases, 2016, 36, pp.408 - 408. ⟨10.1186/s12879-016-1935-y⟩. ⟨hal-01473613⟩