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. 2025 Jan 23;25(1):109.
doi: 10.1186/s12879-025-10506-4.

Fecal carriage of carbapenemase and AmpC-β-lactamase producers among extended spectrum β-Lactamase-producing E. coli and Klebsiella spp. isolates in patients attending hospitals

Zakaria Garba  1   2 , Isidore J O Bonkoungou  3 , Namwin Siourimè Somda  4 , Magloire H Natama  5 , Georges Somé  5 , Lassana Sangaré  6 , Nicolas Barro  3 , Halidou Tinto  5
Affiliations

Fecal carriage of carbapenemase and AmpC-β-lactamase producers among extended spectrum β-Lactamase-producing E. coli and Klebsiella spp. isolates in patients attending hospitals

Zakaria Garba et al. BMC Infect Dis. .

Abstract

Background: Extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE), particularly Escherichia coli and Klebsiella pneumoniae, have been consistently associated with treatment failure, high mortality and morbidity. The emergence of carbapenem resistance among ESBL-PE strains exacerbates the antimicrobial resistance. However, data are very limited in developing countries as Burkina Faso. This study aimed to determine the prevalence of carbapenemase and AmpC-β-lactamase production among ESBL-producing E. coli (ESBL-Ec) and Klebsiella spp. (ESBL-K) isolated from patients' stool in Burkina Faso.

Materials and methods: From January 2020 to June 2022, we isolated 277 ESBL-PE from patients' stool in five hospitals in Burkina Faso. The strains were isolated on ESBL-selective chromogenic media and identified using API20E. The isolates were tested against 15 antimicrobial agents using the disc-diffusion method on Mueller-Hinton (MH) agar. ESBL production was confirmed by double disc synergy method. Carbapenemase and AmpC-β-lactamase production and phenotypic co-resistance were determined.

Results: Among the 277 ESBL-PE strains isolated, 203 were E. coli, and 74 were Klebsiella spp. Of these bacteria, 2.9% were carbapenemase producers and 6.5% were AmpC-β-lactamase producers. The carbapenemase producers were detected at tertiary and secondary hospitals, mainly in hospitalized patients and females, whereas AmpC-β-lactamase producers were detected at all levels of healthcare, predominantly in non-hospitalized patients, male, and under 15 years of age. The co-resistance rates were as high as 82% for fluoroquinolones, 91% for aminoglycosides, and 94% for sulfonamides. Fosfomycin resistance was 2.5% for ESBL-Ec and 50% for ESBL-K.

Conclusion: This study showed that ESBL-PEs co-produce carbapenemase and/or AmpC-β-lactamase. High co-resistances were reported for commonly used antibiotic agents. Therefore, screening for carbapenem-resistant Enterobacterales (CRE) carriage is necessary to limit its spread within hospitals.

Keywords: E. coli; Klebsiella; AmpC-β-lactamase; Carbapenemase; ESBL-PE.

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Conflict of interest statement

Declarations. Ethical aspects: This study is part of the AMRIWA project, which received approval from the health research Ethics Committee of Burkina Faso (N°153-12-2018/CERS). Informed consents were obtained from patients or parents of minor patients for their participation in the study. The study was conducted in accordance with the declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Antimicrobial resistance pattern of ESBL-, ESBL + AmpC-, and ESBL + Carbapenemase-producers
See this image and copyright information in PMC

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