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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Rectal carriage of extended-spectrum beta-lactamase-producing Gram-negative bacilli in community settings in Madagascar
PLoS ONE, Volume 6, No. 7, Article e22738, Year 2011
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Description
Background: Extended-spectrum ß-lactamase-producing Enterobacteria (ESBL-PE) emerged at the end of the 1980s, causing nosocomial outbreaks and/or hyperendemic situations in hospitals and long-term care facilities. In recent years, community-acquired infections due to ESBL-PE have spread worldwide, especially across developing countries including Madagascar. Objectives: This study aimed to determine the prevalence and risk factors of intestinal carriage of ESBL-PE in the community of Antananarivo. Methods: Non-hospitalized patients were recruited in three health centers in different socio economic settings. Fresh stool collected were immediately plated on Drigalski agar containing 3 mg/liter of ceftriaxone. Gram-negative bacilli species were identified and ESBL production was tested by a double disk diffusion (cefotaxime and ceftazidime +/- clavulanate) assay. Characterization of ESBLs were perfomed by PCR and direct sequencing. Molecular epidemiology was analysed by Rep-PCR and ERIC-PCR. Results: 484 patients were screened (sex ratio = 1.03, median age 28 years). 53 ESBL-PE were isolated from 49 patients (carrier rate 10.1%). The isolates included Escherichia coli (31), Klebsiella pneumoniae (14), Enterobacter cloacae (3), Citrobacter freundii (3), Kluyvera spp. (1) and Pantoae sp.(1). In multivariate analysis, only the socioeconomic status of the head of household was independently associated with ESBL-PE carriage, poverty being the predominant risk factor. Conclusions: The prevalence of carriage of ESBL in the community of Antananarivo is one of the highest reported worldwide. This alarming spread of resistance genes should be stopped urgently by improving hygiene and streamlining the distribution and consumption of antibiotics. © 2011 Herindrainy et al.
Authors & Co-Authors
Herindrainy, Perlinot
Laos
Institut de la Francophonie Pour la Médecine Tropicale
Randrianirina, Frédérique
Madagascar, Antananarivo
Institut Pasteur de Madagascar
Ratovoson, Rila
Madagascar, Antananarivo
Institut Pasteur de Madagascar
Ratsima, Elisoa Hariniaina
Madagascar, Antananarivo
Institut Pasteur de Madagascar
Buisson, Yves
Laos
Institut de la Francophonie Pour la Médecine Tropicale
Genel, Nathalie
France, Paris
Sorbonne Université
Decrè, Dominique C.
France, Paris
Sorbonne Université
Arlet, Guillaume A.
France, Paris
Sorbonne Université
Talarmin, Antoine
Madagascar, Antananarivo
Institut Pasteur de Madagascar
Richard, Vincent
Madagascar, Antananarivo
Institut Pasteur de Madagascar
Statistics
Citations: 82
Authors: 10
Affiliations: 3
Identifiers
Doi:
10.1371/journal.pone.0022738
e-ISSN:
19326203
Study Design
Cross Sectional Study
Study Locations
Madagascar