Prevalence of Multidrug-Resistant Enterobacterales Isolated from 2019 to 2020 in a Tertiary Hospital in Dakar-Senegal

Background: Multi-resistant bacteria have emerged as a global threat to human health. In Africa, there are few data on AMR. The objective of this study was to determine antibiotic resistance profile of enterobacteria strains and prevalence of multidrug-resistant bacteria isolated in a university hospital in the suburbs of Dakar.

Methods: Enterobacterales were isolated from a wide range of clinical specimens (urine, pus, blood, catheter tip and bronchoalveolar fluid) from inpatients and outpatients at Medical Biology Laboratory of National University Hospital Center of Pikine from November 2019 to October 2020. Enterobacterales were identified using API 20E. Antimicrobial susceptibility testing was performed with ATB G-EU (08) (bio Mérieuxs®) on all enterobacterales in accordance with CA-SFM/EUCAST 2020 guidelines.

Results: Of the 3422 different clinical specimens tested, 623 (17.1%) were culture positive. Enterobacteriaceae accounted for 57.6% (n=359) of the strains; Escherichia coli and Klebsiella pneumoniae were predominant isolates with 53.5% and 20.6% respectively. Seventy-four(%) strains of enterobacterales were ESBL. Antibiotic resistance patterns showed a prevalence of multidrug resistant strains of 32.6%. The most active antibiotics on isolates were imipenem (25%), followed by amikacin (15%), fosfomycin (12%) and piperacillin-tazobactam (10%).

Conclusion: High rates of ESBL and multidrug-resistant strains were found in both outpatients and inpatients. These results indicate need for an active surveillance system for antimicrobial resistance. Also, the application of good hospital hygiene practices and antibiotic therapy adapted to local data must be adopted.