High faecal carriage of multi-drug resistant Enterobacteriaceae and other gram negative strains among food handlers in Cosmopolitan Cities of The Gambia

The Gambia; Ollie Diane Riley; Haruna S. Jallow; Abou Kebbeh; Yaya  Camara; Ebrima Barrow; Aida Fatou Ceesay; Modou Lamin  Jarju; Kalifa Sanneh; Sainey B.F. Ceesay; Amadou Woury Jallow; Ignatius Baldeh; Sana M Sambou; Antoine Andremont

doi:10.30574/gscbps.2020.13.2.0364

Authors

The Gambia National Public Health Laboratories, Bertil Herding High way, Kotu Lay out, Ministry of Health.
Ollie Diane Riley National Public Health Laboratories, Bertil Herding High way, Kotu Lay out, Ministry of Health.
Haruna S. Jallow National Public Health Laboratories, Bertil Herding High way, Kotu Lay out, Ministry of Health.
Abou Kebbeh National Public Health Laboratories, Bertil Herding High way, Kotu Lay out, Ministry of Health.
Yaya Camara Epidemiology and Disease Control Unit, Bertil Herding High way, Kotu Lay out Ministry of Health, The Gambia.
Ebrima Barrow Microbiology Laboratory department, Edward Francis Small Teaching Hospital ,Banjul, Ministry Of Health, The Gambia.
Aida Fatou Ceesay National Public Health Laboratories, Bertil Herding High way, Kotu Lay out, Ministry of Health.
Modou Lamin Jarju National Public Health Laboratories, Bertil Herding High way, Kotu Lay out, Ministry of Health.
Kalifa Sanneh National Public Health Laboratories, Bertil Herding High way, Kotu Lay out, Ministry of Health.
Sainey B.F. Ceesay National Public Health Laboratories, Bertil Herding High way, Kotu Lay out, Ministry of Health.
Amadou Woury Jallow World Health Organization, Country Office, Kotu Lay out, The Gambia.
Ignatius Baldeh National Public Health Laboratories, Bertil Herding High way, Kotu Lay out, Ministry of Health.
Sana M Sambou Epidemiology and Disease Control Unit, Bertil Herding High way, Kotu Lay out Ministry of Health, The Gambia.
Antoine Andremont University Paris-Diderot Medical School, 5 Rue Thomas Mann, Paris, France.

DOI:

https://doi.org/10.30574/gscbps.2020.13.2.0364

Keywords:

Fecal Carriage, Multi-Drug Resistant, Enterobacteriaceae, Food Handlers, The Gambia

Abstract

The introductions of advanced antibiotics have triggered complex versions of resistant genes in gram-negative bacteria. In a generation witness limited discovery of antibiotics makes this phenomenon a major public health threat. This study aims to establish the fecal carriage rate of multidrug-resistant Enterobacteriaceae strains among food handlers.

Data was extracted from a prospective cross-sectional study – ‘Prevalence and risk factors of fecal carriage of Extended Spectrum β-Lactamase producing Enterobacteriaceae amongst food handlers in Lower Basic Schools in West Coast region of The Gambia. The study enrolled 600 randomly selected food handlers (565 of which had complete data set) from 60 lower basic schools in 7 districts in the West Coast Region of The Gambia. Stool samples were collected from the participants and screened for resistance to cefotaxim. Isolated organisms were further tested for susceptibility to cephalosporins, carbapenems, fluoroquinolones and other families of antimicrobials as per Clinical Standard Laboratory Institute guidelines. The association of risk factors to fecal carriage of resistant Enterobacteriacea was performed using Pearson Chi squared and fishers exact (P<0.05).

Results confirmed that the prevalence of Enterobacteriaceae by resistance to cefotaxime was 15.8%. 23 genus and 89 species of resistant strains were isolated. All isolates were 100% resistant to cephalosporins such as ceftriazone, cefotaxime and cefuroxime, except ceftazidime (92%). Resistance to ciprofloxacin (fluoroquinolone) was measured at 50%. Only 1.2% was resistant to imipenem (carbapenem). Most isolates were resistant to ampicillin, nitrofurantoine, erythromycin, tetracycline and cotrimaxole. Majority of the identified Enterobacteriaceae were Enterobacter aerogene (14%), Klebsiella pneumoniea (12%) and Escherichia coli (7%).

This study found a high prevalence of fecal carriage multi-drug resistant Enterobacteriaceae among food handlers, mostly women, in The Gambia. The irrational prescription and use of antibiotics is a major risk factor for the proliferation of antibiotic resistance. Well-conducted surveillance is essential to implement effective control measures for the spread of antibiotic resistance urgently receommended.

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