The prevalence and drug resistance pattern of extended spectrum β-lactamases (ESBLs) producing Enterobacteriaceae in Africa

Abstract

Extended spectrum β-lactamases (ESBLs) are a group of enzymes that can hydrolyze a variety of β-lactams including fourth generation cephalosporins and compromise the efficacy of all β-lactams, except cephamycins and carbapenems. In the worldwide, the ESBL group of enzymes are found widely and causes a severe infection on human health which leads to various diseases. This review primarily focusses on analyzing the prevalence and drug resistance patterns in the African continent. From the earlier reported data shown only the minimal amount of surveillance information's has been summarized with respect to antimicrobial resistance on ESBLs producing Enterobacteriaceae both in hospital and community settings. To bring the present scenario in limelight, the present study explores the prevalence of ESBL-producing Enterobacteriaceae in various countries in Africa and specifically, to identify most common ESBL genes in hospital and community. The observation was initiated with the exhaustive literature search using PubMed and other databases to broaden the study from the earlier investigations in the African countries concerned about the prevalence rate of ESBL producing Enterobacteriaceae. Further, this study was extended to review various hypothesis of the hydrolytic mechanism, which was detailed by several authors performed earlier through computational approaches. Interestingly, the ESBLs class A and D were found to be common classes in Africa, with the gene CTX-M-15 being most prevalent. Notably, the present review highlights the prevalence on individual countries in Africa and it is extremely significant to prevent the dissemination of ESBL-producing Enterobacteriaceaea. Hence, this review on surveillance will be the benchmark to enhance the research on antimicrobial resistance patterns for all classes and genes. Furthermore, explored in-sights in this paper will be helpful for the further investigations to develop quicker, cost effective, and reliable diagnostic strategies and new effective therapies.

Keywords: Africa; Community; ESBL genes; Enterobacteriaceae; Extended-spectrum beta lactamases; Hospital; Prevalence.