Surveillance of Resistance to Third-Generation Cephalosporins in Four Regions of Senegal (Saint-Louis, Diourbel, Kaolack, and Dakar) between January 2020 and September 2021
Antibiotic resistance remains a major public health problem, and if no action is taken by 2050, mortality related to multidrug resistance is expected to reach 10 million deaths per year. In Senegal, most studies and interventions on multidrug resistance surveillance have been limited to Dakar. Against this background, the present study was undertaken with the primary aim of surveilling resistance patterns to third-generation cephalosporins (3GCs), the most extensively used antibiotic class in the inpatient setting, particularly in acute care and emergency contexts. Methods: This was a prospective study conducted in the hospitals of Diourbel, Kaolack, Le Dantec (Dakar), Matlaboul Fawzeini Hospital in Touba, and the regional laboratory of Kaolack. Bacterial isolates were identified based on morphological, cultural, and biochemical characteristics. Antimicrobial susceptibility testing was performed according to the recommendations of the French Society of Microbiology Antibiogram Committee (CA-SFM) in force. Data were first recorded in registers, entered into Excel, and analyzed using SPSS. Results: Between January 2020 and September 2021, 329 Enterobacterales isolates resistant to third-generation cephalosporins were collected. These isolates were mainly recovered from Saint-Louis Regional Hospital (n = 130; 39.5%), the Regional Laboratory of Kaolack (n = 55; 16.71%), and Le Dantec Hospital (n = 80; 24.31%). The majority of isolates were obtained from urine samples (n = 178; 54.10%), followed by pus specimens (n = 64; 19.45%). Resistance to 3GCs was mainly mediated by extended-spectrum beta-lactamase (ESBL) production (79.63% of isolates), while 3.34% of isolates were resistant to carbapenems. Escherichia coli and Klebsiella pneumoniae were the main ESBL-producing species, with prevalences of 55.9% and 25.6%, respectively. Conclusion: These findings show that ESBL-producing and 3GC-resistant Enterobacterales represent a major resistance issue reported in clinical laboratories. Antimicrobial resistance control efforts should be implemented at the national level to better understand gene distribution and reduce morbidity and mortality associated with multidrug-resistant bacteria.
References
[1]
Rossolini, G.M. and Mantengoli, E. (2008) Antimicrobial Resistance in Europe and Its Potential Impact on Empirical Therapy. ClinicalMicrobiologyandInfection, 14, 2-8. https://doi.org/10.1111/j.1469-0691.2008.02126.x
[2]
Doern, C.D. (2024) Classification of Medically Important Bacteria. In: Tan, Y.W., et al., Eds., MolecularMedicalMicrobiology, Elsevier, 9-21. https://doi.org/10.1016/b978-0-12-818619-0.00029-0
[3]
Lam, J.C., Lang, R. and Stokes, W. (2023) How I Manage Bacterial Prostatitis. Clinical Microbiology and Infection, 29, 32-37. https://doi.org/10.1016/j.cmi.2022.05.035
[4]
Bonnet, R. (2012) Bêtalactamines et entérobactéries. In: Courvalin, P., Ed., Antibio-gramme (3rd Edition), éditions ESKA, 165-188.
[5]
Mkaouar, D., Mahjoubi, F., Mezghani, S., Znazen, A., Ktari, S. and Hammami, A. (2008) étude de la résistance des entérobactéries aux céphalosporines de troisième génération dans les h？pitaux de Sfax, Tunisie (1999-2005). Médecine et Maladies Infectieuses, 38, 293-298. https://doi.org/10.1016/j.medmal.2007.11.017
[6]
Salah, F.D., Sadji, A.Y., Akolly, K., Bidjada, B., Awoussi, K.S., Abaya, A.M., et al. (2022) Augmentation de la résistance aux antibiotiques des Entérobactéries isolées à l’Institut National d’Hygiène de Lomé de 2010 à 2017. Journal of Interventional Epidemiology and Public Health, 4, Article 3. https://doi.org/10.37432/jieph.supp.2021.4.3.03.3
[7]
Robin, F., Beyrouthy, R., Bonacorsi, S., Aissa, N., Bret, L., Brieu, N., et al. (2017) Inventory of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae in France as Assessed by a Multicenter Study. Antimicrobial Agents and Chemotherapy, 61, e01911-16. https://doi.org/10.1128/aac.01911-16
[8]
Pitout, J.D.D., Nordmann, P., Laupland, K.B. and Poirel, L. (2005) Emergence of Enterobacteriaceae Producing Extended-Spectrum β-Lactamases (ESBLs) in the Community. Journal of Antimicrobial Chemotherapy, 56, 52-59. https://doi.org/10.1093/jac/dki166
[9]
Flores-Mireles, A.L., Walker, J.N., Caparon, M. and Hultgren, S.J. (2015) Urinary Tract Infections: Epidemiology, Mechanisms of Infection and Treatment Options. Nature Reviews Microbiology, 13, 269-284. https://doi.org/10.1038/nrmicro3432
[10]
Stamm, W.E. and Norrby, S.R. (2001) Urinary Tract Infections: Disease Panorama and Challenges. The Journal of Infectious Diseases, 183, S1-S4. https://doi.org/10.1086/318850
[11]
Mbaye, K.D., Lakhe, N.A., Sylla, K., Ndiaye, R., Diallo, V.M.P.C., Ka, D., et al. (2018) Enterobacterial Infections Diagnosed at the Clinic of Infectious Diseases of Fann Hospital (2013-2014) Dakar, Senegal. Advances in Infectious Diseases, 8, 217-228. https://doi.org/10.4236/aid.2018.84018
[12]
Le Hello, S., Gravey, F., Lazberg, A. and Thibon, P. (2024) Enquête FLASH: épidémiologie génomique des entérobactéries résistantes aux céphalosporines de 3ème génération en région. Médecine et Maladies Infectieuses Formation, 3, S34-S35. https://doi.org/10.1016/j.mmifmc.2024.04.068
[13]
Ndoye, M., Daffe, S.M., Diop, M., Gueye, M.W., Ngom, M., Wade, M.B., et al. (2025) Resistance Profile of Escherichia colis Trains Isolated at the Main Hospital in Dakar Retrospective Study over 10 Years. BMC Microbiology, 25, Article No. 536. https://doi.org/10.1186/s12866-025-04202-1
[14]
Guembe, M., Cercenado, E., Alcalá, L., Marín, M., Insa, R. and Bouza, E. (2008) Evolution of Antimicrobial Susceptibility Patterns of Aerobic and Facultative Gram-Negative Bacilli Causing Intra-Abdominal Infections: Results from the SMART Studies 2003-2007. Revista Espanola de Quimioterapia, 21, 166-173.
[15]
Hamprecht, A., Rohde, A.M., Behnke, M., Feihl, S., Gastmeier, P., Gebhardt, F., et al. (2016) Colonization with Third-Generation Cephalosporin-Resistant Enterobacteriaceae on Hospital Admission: Prevalence and Risk Factors. Journal of Antimicrobial Chemotherapy, 71, 2957-2963. https://doi.org/10.1093/jac/dkw216
[16]
Randrianirina, F., Vedy, S., Rakotovao, D., Ramarokoto, C.E., Ratsitohaina, H., Carod, J.F., et al. (2009) Role of Contaminated Aspiration Tubes in Nosocomial Outbreak of Klebsiella pneumoniae Producing SHV-2 and CTX-M-15 Extended-Spectrum β-Lactamases. JournalofHospitalInfection, 72, 23-29. https://doi.org/10.1016/j.jhin.2009.02.004
[17]
Laupland, K.B., Church, D.L., Vidakovich, J., Mucenski, M. and Pitout, J.D.D. (2008) Community-Onset Extended-Spectrum β-Lactamase (ESBL) Producing Escherichia coli: Importance of International Travel. JournalofInfection, 57, 441-448. https://doi.org/10.1016/j.jinf.2008.09.034
[18]
Lo, S., Robin, F., Ba-Diallo, A., Diallo, O.F., Dia, M.L., Beyrouthy, R., et al. (2017) Détection fortuite de cmy-2 et dha-1 chez des isolats d’Escherichia coli producteurs de BLSE au Sénégal. BulletindelaSociétédepathologieexotique, 110, 221-223. https://doi.org/10.1007/s13149-017-0573-y
[19]
Breurec, S., Bouchiat, C., Sire, J., Moquet, O., Bercion, R., Cisse, M.F., et al. (2016) High Third-Generation Cephalosporin Resistant Enterobacteriaceae Prevalence Rate among Neonatal Infections in Dakar, Senegal. BMCInfectiousDiseases, 16, Article No. 587. https://doi.org/10.1186/s12879-016-1935-y
[20]
Breurec, S., Guessennd, N., Timinouni, M., Le, T.T.H., Cao, V., Ngandjio, A., et al. (2013) Klebsiella pneumoniae Resistant to Third-Generation Cephalosporins in Five African and Two Vietnamese Major Towns: Multiclonal Population Structure with Two Major International Clonal Groups, CG15 and CG258. ClinicalMicrobiologyandInfection, 19, 349-355. https://doi.org/10.1111/j.1469-0691.2012.03805.x
