Antibiotic resistance pattern of extended-spectrum-beta lactamases-producing Escherichia coli isolated from pregnant women and their new born

Abstract

The incidence of healthy pregnant women carrying CTX-M-type extended-spectrum beta-lactamase (ESBL)-producing E. coli and their transmission to neonates is increasing worldwide. ESBL-E coli and especially the carriage of CTX-M-type causes early or late onset of neonatal sepsis, resulting in increased morbidity and mortality rates. Although maternal carriage and maternal-neonatal transmissions of ESBL-E have been reported in several countries, the prevalence of CTX-M-type ESBL-producing E. coli in pregnant women and its transmission to newborns at birth in Cameroon has not been reported yet. We describe here the carriage of CTX-M-type ESBL-producing E. coli pregnant women in neonatal ward of the Yaoundé gyneco-obstetric and pediatric hospital and their transmission to newborns. Among the 102 pregnant women and their newborns present in the ward, 88 (86.3%) and 75 (73.5%) E. coli strains were detected in rectal colonization, respectively. Antibiotic susceptibility testing of E. coli isolated from the mothers indicated a higher resistance rate to antibiotics of the β-lactams and sulfamide families, while the resistances to other antibiotic families (aminosides, quinolones and fluoroquinolones) were low. Comparatively, only cefotaxime (100%) showed a higher resistance rate to E. coli isolated from newborns. This may suggest a different source of contamination between mothers and newborns. Moreover, the rate of carriage of CTX-M-type ESBL-producing E. coli in pregnant mother and their newborns were 30.7 % and 14.7 %, respectively. This suggests that newborns had other colonization sources than the mothers. Indeed, multiple regression analysis indicated that newborns were exposed to CTX-M-type ESBL-producing E. coli from mothers and that from the hospital environment (eg. caregivers). Overall, the current investigation may provide insight on establishing an efficient therapeutic strategy against materno-neonatal and nosocomial transmission of CTX-M-type ESBL-producing E. coli.