Prevalence of CTX-M beta-Lactamases in Escherichia coli from community-acquired urinary tract infections and associated risk factors among women in Cameroon

Background: In recent years, a worldwide dissemination of CTX-M beta-lactamase-type in Escherichia coli strains isolates from community-acquired urinary tract infections (CA-UTI) has been observed. However little is known on the prevalence and risk factors of this global threat in developing countries. Objective: The aim of this study was to study the prevalence and risk factors for CA-UTI in Yaoundé, Cameroon. Methods: Eighty six patients with urinary E.coli infection recruited from 10 health structures in the town of Yaoundé, Cameroon. After taking the first urine, faeces were collected from the patients for the study of the intestinal flora. The sample collection of faeces was done on a selected gel of enterobacteria resistant to third generation of cephalosporin. The molecular typing of extended-spectrum -lactamase (ESBL) was carried out. Results: Eighty-six strains of E. coli from 86 patients were included. We found that 39 (45.3%) strains produced an extendedspectrum beta-lactamase. Among risk factors, previous use of antibiotic and the dry season were associated with the presence of an ESBL-producing strain in the urine. All ESBL were identified as CTX-M. The production of CTX-M was found to be significantly associated with resistance to fluoroquinolones, aminoglycosides and to the association of trimethoprim-sulfamethazole. Conclusions: The prevalence of CTX-M ESBL in Yaoundé, Cameroon, provides new evidence on the global dissemination of CTX-M and the extent of this phenomenon in developing countries.