Screening for Beta-Lactamases Producing Bacteria and Other Resistant Bacteria among Patients Admitted to the Emergency Unit at the Yaoundé University Teaching Hospital, Cameroon

Aims: This study aimed to screen for Beta Lactamases (BLs) and other resistant bacteria among patients admitted to the emergency unit of the Yaoundé University Teaching Hospital (YUTH).

Study Design: This study was a cross-sectional hospital-based study.

Place and Duration of Study: This study was conducted at the Bacteriology unit of the YUTH, Yaoundé- Cameroon between February to June 2020.

Methodology: Seventy-Five urine samples were collected from newly admitted patients at the emergency unit of the YUTH and bacteria species were identified basis on their culture characteristics, Gram morphology, and biochemical tests. The isolates were screened from the production of extended-spectrum beta-lactamases (ESBLs) and AmpC BLs using the Double disk synergy method and Disk approximation methods respectively. These isolates were later subjected to antimicrobial susceptibility testing using the disk diffusion method.

Results: Out of the 75 urine analyzed, 14 (18.7%) were found positive for Urinary Tract Infection. Fourteen bacteria species were isolated identified and enumerated as E. coli (5), Klebsiella species (4), Citrobacter species (2), Proteus species (2), and Enterobacter species (1). A high level of resistance was observed with Amoxicillin clavulanic acid, Cefuroxime, and Ceftazidime while a high level of sensitivity was observed among carbapenem antibiotics. Eight of 14 isolated bacteria were BLs producers, of which 5 were sorely ESBL producers, 2 co-producers (ESBL + AmpC), and 1 AmpC producer. The overall positive rate of BLs in the study population was 10.7%. Again, patient origin and previous antibiotic use were significantly associated with BLs prevalence p-value of .01 and .04 respectively.

Conclusion: The high prevalence of the ß- lactamases in the Emergency unit emphasizes the need for continuous surveillance in the Emergency unit to detect resistant strains, strict guidelines for antibiotic therapy, and the implementation of infection control measures to reduce the increasing burden of antibiotic resistance.

Keywords: Beta-lactamase, prevalence, urinary tract infection, extended spectrum beta-lactamases, ampc beta-lactamases