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.
Highlights
Antimicrobial resistance has become a major threat to the control of infectious diseases and to public health
This study found a high prevalence of fecal carriage multi-drug resistant Enterobacteriaceae among food handlers, mostly women, in The Gambia
This study aims to gain some insight into the antibiotic sensitivity of Enterobacteriaceae in the Gambia, using bacterial isolates obtained from stool samples of food handlers in lower basic schools in the West Coast Region of the Gambia
Summary
Antimicrobial resistance has become a major threat to the control of infectious diseases and to public health. The limited discovery of antibiotics makes this phenomenon all the more alarming. In places with limited diagnostic facilities and treatment options, it is a major contributing factor to morbidity and mortality [7]. Resistant Enterobacteriaceae strains have been considered to be the most prevalent causative agents of hospital – and community-acquired infections [8]. Multi-resistant strains have been detected in foods and food animals. It has been hypothesized that foods are probably one of the most important vehicles for disseminating resistant bacterial strains within the general population [9]
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