Carriage of multidrug-resistant organisms among patients and healthcare workers in haemodialysis units in public hospitals in Yaounde, Cameroon

Résumé fourni par la source

Background: The emergence and spread of Multidrug-resistant organisms (MDRO) represent a major public health issue, particularly amongst patients in haemodialysis units. Haemodialysis units regularly receive patients with renal failure, yet almost all hospitals in Cameroon with haemodialysis units lack a resistance surveillance program. The lack of data on the epidemiology of MDRO in haemodialysis units led us to conduct this study, with the aim of determining the frequency of MDRO carriage among patients and healthcare workers in haemodialysis units in Cameroon. Methods: Nasal and rectal swabs were collected from patients and healthcare staff in two referral hospitals of Yaounde, between November 2023 and April 2024. Bacteria isolated on selective media were identified by biochemical tests and mass spectrometry. Antibiotic resistance profiles and resistance phenotypes were detected according to EUCAST/CASFM 2023 recommendations. Results: A total of 155 participants were selected, including 130 patients and 25 staff members. Several comorbidities were identified among the patients, including cardiovascular diseases and infections. From the 275 samples collected we isolated 59 (21.45%) MDRO with 54 (91.2%) from patients and 5 (8.48%) from healthcare personnel. Methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), third-generation cephalosporinase-producing Enterobacteriaceae (3CPE) and extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) were more represented among patients compared to healthcare personnel with no significant difference in the two hospitals. There was no significant difference between the age groups (P=0.438). The resistance profile of MDRO was similar in the two hospitals. Conclusion: This study revealed a high prevalence of MDRO in the haemodialysis unit, highlighting the need for systematic screening of patients on arrival at the haemodialysis unit and for the strengthening of standard precautions.