Bloodstream infections initiated by ESBL-producing Escherichia coli in neonates and infants at two hospitals in Yaoundé, Cameroon

Abstract

Early diagnosis and probabilistic antibiotic therapy based on known bacterial ecology and antibiotic sensibility can reduce mortality and morbidity in pathologies caused by a bacterial infection. This study aimed at determining the prevalence and risk factors of extended-spectrum β-lactamases (ESBLs)-producing Escherichia coli isolated from blood cultures of neonates and infants population. We conducted a cross-sectional study during which pathogenic bloodstream isolates were identified. Antibiotic susceptibility test was performed on Escherichia coli isolates and phenotypic confirmation of ESBL production by Escherichia coli was performed by a double-disc synergy test. Over the course of this study, 298 blood cultures were performed and 129 (43.3%) positive cultures were obtained. Of the 129 bacterial isolates, 90 (69.7%) were Escherichia coli and 39 (30.2%) were other bacteria strains that included Klebsiella oxytoca, Streptococcus pneumonia, and Coagulase-negative staphylococci. Antibiotic susceptibility test indicated that Escherichia coli isolates were resistant to cephalosporin, penicillin, sulfonamide, and aminoglycoside antibiotic families. Further analysis indicated that 31 (34.4%) Escherichia coli strains were ESBL producers and risk factors for bloodstream infection by ESBL-producing Escherichia coli were prior to exposure to antibiotics and immune system depression. These findings clearly extend our understanding of the type of resistant initiated by ESBL-producing Escherichia coli in bloodstream infection of neonates, and infants and also provides useful information that can guide the establishment of an efficient therapeutic strategy for the community-and hospital-acquired bloodstream infection.