TITLE:
Risk Factors and Prevalence of Mother to New-Born Transmission of Carbapenemase Producing Enterobacteriaceae in Two Hospitals in Yaounde, Cameroon
AUTHORS:
Cecile Ingrid Djuikoue, Noemy Tchinda Chounna, Paule Dana Djouela Djoulako, Farid Wega, Joelle Djamfa Nzenya, Cedric Seugnou Nana, Dorine Ngatcheu Ekeu, Blondelle Kitio Messeu, Laurene Nzangem Doumene, Joviale Magne Talla, Mireille Fock, Benjamin D. Thumamo Pokam
KEYWORDS:
Drug Resistance, Carbapenems, Pregnant Women, Vertical Transmission, Cameroon
JOURNAL NAME:
Open Journal of Medical Microbiology,
Vol.13 No.1,
March
24,
2023
ABSTRACT: Background: In African countries,
where the burden of neonatal sepsis is the highest, the spread of
Carbapenemases Producing Enterobacteriaceae (CPE) in the community, potentially contributing to neonatal
mortality, is a public health concern. The transmission routes are not
well defined, particularly the possible key role played by pregnant women. The
aim of this study was to understand the neonatal acquisition of CPE in
Yaounde, Cameroon. Methods: A transversal analytical study was conducted in
an urban area. Maternal stool samples during delivery and the first stool from
their new-born were collected and cultured to isolate Enterobacteria. After
isolation, characterization using
API20E identification system, and antibiotic susceptibility testing were
performed according to the Antibiogram Committee of the French Society of Microbiology. Carbapenemases detection
was done on each carbapenem-resistant strain using the Modified Hodge Test (MHT)
and their classification using the synergy tests with different inhibitors. Results: Out of the 55 CPE isolates identified, Escherichia
coli was the most encountered bacteria both in mothers (n = 18, 50.00%) and
infants (n = 11, 57.89%). Class B and D carbapenemases were found both
in mothers and infants. The estimated prevalence of vertical transmission in
our study, was 10% (n = 12). Logistic regression showed that CPE carriage in
mothers and CPE acquisition in their new-borns were independently associated
with the presence of greenish amniotic fluid (OR = 7.33, p 0.0001 in mothers and OR = 4.09, p = 0.0086 in new-borns). Conclusion: Our results highlight the non-negligeable role played by pregnant women in
the neonatal acquisition of CPE.