Prevalence and risk factors for faecal carriage of Extended Spectrum β-lactamase producing Enterobacteriaceae among food handlers in lower basic schools in West Coast Region of The Gambia

• Published in: PloS one Vol. 13; no. 8; p. e0200894
• Main Authors: Sanneh, Bakary, Kebbeh, Abou, Jallow, Haruna S, Camara, Yaya, Mwamakamba, Lusubilo Witson, Ceesay, Ida Fatou, Barrow, Ebrima, Sowe, Fatou O, Sambou, Sana M, Baldeh, Ignatius, Jallow, Alpha, Jorge Raul, Matheu Alvarez, Andremont, Antoine
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 13.08.2018; Public Library of Science (PLoS)
• Subjects: Adult; Agar; Antibiotics; Antimicrobial agents; Bacteria; beta-Lactamases - biosynthesis; Biology and Life Sciences; Carbapenemase; Carrier State - epidemiology; Carrier State - microbiology; Cefotaxime; Cefoxitin; Ceftazidime; Cephalosporins; Chemotherapy; Clavulanic acid; Coastal environments; Coastal zone; Cross-Sectional Studies; Disease control; Drug Resistance, Bacterial; E coli; Enterobacteriaceae; Enterobacteriaceae - drug effects; Enterobacteriaceae - enzymology; Enterobacteriaceae - isolation & purification; Enterobacteriaceae Infections - epidemiology; Enterobacteriaceae Infections - microbiology; Epidemiology; Feces - microbiology; Female; Food; Food Handling; Food Microbiology; Food sources; Gambia - epidemiology; Handlers; Health care facilities; Humans; Klebsiella; Laboratories; Male; Medical research; Medicine and Health Sciences; Multidrug resistance; Outbreaks; People and Places; Phenotypes; Prevalence; Public health; Risk analysis; Risk Factors; Schools; Social Sciences; Teaching hospitals; Urinary tract infections; Gambia
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0200894

The isolation of Extended spectrum βlactamase (ESBLs) producing Enterobacteriaceae among food handlers and their implication as sources of food borne outbreaks are a public health concern. This study seeks to investigate the prevalence of faecal carriage of these bacteria among food handlers in the West Coast Region of The Gambia. This study enrolled 600 participants from 60 Lower Basic Schools in West Coast Region of the country. Stool samples collected from the participants were presumptively screened for the ESBLs producing Enterobacteriaceae, using Drigalski agar, supplemented with 2mg/L cefotaxime. The bacterial colonies that grew on each Drigalski agar were tested for ESBL production by the double disk synergy test as recommended by Clinical and Laboratory Standard Institute (CLSI-2015). The confirmatory analysis for ESBL was determined as the zone of inhibition of cefotaxime and/or ceftazidime to ≥5mm from that of cefotaxime /clavulanicacid and/or ceftazidime/clavulanic acid. The presumptive screening of isolates for AmpC phenotypes was done by testing the organism against cefoxitin. The prevalence of the ESBL carriage was presented in percentages. The association of risk factors to the faecal carriage of ESBLs producing Enterobacteriaceae was performed by Pearson Chi-squared and Fishers Exact at (p ≤ 0.05). The prevalence of faecal carriage ESBL producing Enterobacteriaceae among food handlers was 5.0% (28/565). We found50% (14/28) and3.57% (1/28) ESBL producing bacteria were presumptive AmpC and carbapenemase resistance phenotype. Themost abundant ESBL producing Enterobacteriaceae were Klebsiella spp 32.1% (9/28) and Escherichia spp 28.6% (8/28). The use of antibiotics in the last 3 months was found to be significantly associated (P = 0.012) with the faecal carriage of ESBLs producing Enterobacteriaceae. The prevalence of faecal carriage of ESBLs producing Enterobacteriaceae among food handlers in the Gambia is low. The history to use of the antibiotics in the last three months was found to be significantly associated with this prevalence. Therefore, the institution of a robust antimicrobial surveillance and treatment of patients with such infections are necessary to curb the spread of these multidrug resistant bacteria in the country. Rational prescription and usage of the antibiotics especially cephalosporin should be advocated both in public and private health facilities.