Background: Urinary tract infections (UTIs) are a substantial global health concern, exacerbated by the widespread use of antibiotics and leading to the development of multidrug-resistant strains. The aim of this study was to analyze the temporal patterns of Escherichia coli and Klebsiella pneumoniae UTIs and antibiotic resistance, taking into account various sociodemographic, clinical, and climatic factors within the study population. Methods: A total of 3026 urine samples from patients of all ages were analyzed over a period of five years by standard microbiological methods. Climatic data for the study area were also collected. Univariate and multivariate logistic regression analyses were performed to measure the impact of sociodemographic, clinical and climatic parameters on the occurrence of UTIs. Results: The study showed a 31.4% prevalence of UTIs among the population. Notably, there was a significant increase in pyelonephritis between 2019 and 2023 (p < 0.01). Furthermore, a significant association was found between cystitis and the long dry season, as well as the short rainy season. Furthermore, Escherichia coli and Klebsiella pneumoniae exhibited resistance to beta-lactams, quinolones, and co-trimoxazole. The resistance of Escherichia coli isolated from cystitis to nitrofurantoin showed a significant increase over the years (p < 0.04). Principal component analysis (PCA) suggested that humidity may play a role in the emergence of multidrug-resistant strains of Escherichia coli and Klebsiella pneumoniae. Conclusions: UTIs show variability according to various sociodemographic, clinical, and climatic factors, with a higher risk of complications seen in individuals aged ≤ 17 years. It is important to note that cases of pyelonephritis have been increasing over time, with a noticeable seasonal variation. This study suggests that humidity may play a role in promoting antibiotic multidrug resistance in Escherichia coli and Klebsiella pneumoniae.

Data collection and monitoring of carbapenemase-producing (CP) Gram-negative bacteria (GNB) are often limited. This study determined CP-GNB prevalence in Gabon and the genetic origins of the resistance genes. From January 2016 to March 2018, 869 clinically significant GNB isolates from inpatients and outpatients, and 19 fecal samples (inpatients) were analyzed in the main hospitals of Gabon. Fecal samples were screened using ChromID^® CARBA SMART selective chromogenic medium biplates. Species were identified by matrix-assisted laser desorption ionization–time of flight mass spectrometry. Antibiotic susceptibility was tested using the disk diffusion method on Müller–Hinton agar, and resistance genes were assessed by multiplex polymerase chain reaction and sequencing. Overall, 1.61% of clinical isolates (14 of 869) and 5.26% of fecal samples (1 of 19) were CP-GNB. The CP-GNB rate was higher among inpatients (2.98%) than outpatients (0.33%), in intensive care units (28.57%, 4 of 14), and in urine samples (35.71%, 5 of 14). The most common CP-GNB were Klebsiella pneumoniae (53.33%) and Acinetobacter baumannii (26.67%). bla_OXA-48 was the predominant carbapenemase-encoding gene (40%), followed by bla_NDM-5 (33.33%). The A. baumannii multilocus sequence types ST2 and ST78, Enterobacter cloacae ST78, Escherichia coli ST2, and K. pneumonia ST48 and ST147 were found. These data indicate that CP bacteria are present in clinical and carriage samples. Preventive measures are needed to avoid the spread of resistance genes.

In Gabon, few data exist on extended-spectrum beta-lactamases-producing Enterobacteriaceae (ESBL-PE). This study investigated ESBL-PE prevalence and the associated resistance genes in clinical samples ( n = 5,956) and anal swabs ( n = 78) analyzed in eight hospitals and a medical analysis laboratory in Gabon from January 2016 to March 2018. Matrix-Assisted Laser Desorption Ionization–Time Of Flight (MALDI-TOF) mass spectrometry analysis identified 790 Enterobacteriaceae isolates ( n = 712 clinical samples and n = 78 fecal samples). ESBL-PE prevalence (Müller-Hinton agar disk diffusion method and double-disk synergy test) was 11.8% (84/712) in clinical samples (15.5% from inpatients and 7.1% from outpatients; p < 0.05) and 16.7% (13/78) in carriage isolates. Most ESBL-PE were isolated from urine samples (46/84). In clinical and carriage ESBL-PE isolates, Escherichia coli was predominant (42.8% and 61.5%; phylogroups A, B1, B2, and D), followed by Klebsiella pneumoniae (41.7% and 23.1%). Multiplex PCR and bi-directional sequencing showed that CTX-M group 1 (blaCTX-M-15) was predominant in clinical and carriage ESBL-PE (94% and 92.3%) among which 85.7% and 92.3% also harbored one to three β-lactamase-encoding genes (blaTEM-1, blaOXA-1, or blaSHV-1). Resistance genes were detected in all hospitals in Gabon. ESBL-PE prevalence in Gabon has not reached alarming levels yet, but corrective and monitoring measures are needed to curb their emergence.

Background. In Central Africa, it is difficult to tackle antibiotic resistance, because of a lack of data and information on bacterial resistance, due to the low number of studies carried out in the field. To fill this gap, we carried out a systematic review of the various studies, and devised a molecular epidemiology of antimicrobial resistance from humans, animals and the environmental samples. Method. A systematic search of all publications from 2005 to 2020 on bacterial resistance in Central Africa (Gabon, Cameroon, Democratic Republic of Congo, Central African Republic, Chad, Republic of Congo, Equatorial Guinea, São Tomé and Príncipe, Angola) was performed on Pubmed, Google scholar and African Journals Online (AJOL). All circulating resistance genes, prevalence and genetic carriers of these resistances were collected. The study area was limited to the nine countries of Central Africa. Results. A total of 517 studies were identified through a literature search, and 60 studies carried out in eight countries were included. Among all articles included, 43 articles were from humans. Our study revealed not only the circulation of beta-lactamase and carbapenemase genes, but also several other types of resistance genes. To finish, we noticed that some studies reported mobile genetic elements such as integrons, transposons, and plasmids. Conclusion. The scarcity of data poses difficulties in the implementation of effective strategies against antibiotic resistance, which requires a health policy in a ‘One Health’ approach.

Background: In Gabon, studies on the characterization of extended-spectrum beta-lactamase-producing Escherichia coli in young children with diarrhoea are almost nonexistent. The objective was to evaluate the prevalence of antibiotic resistance to extended-spectrum beta-lactamase-producing Escherichia coli in children at public hospitals in Franceville, Gabon. Methods: Seventy diarrhoea faecal samples were collected from children aged 0–5 years. The culture and isolation of colonies were carried out on MacConkey agar. The colonies were identified using VITEK 2. The determination of the extended-spectrum beta-lactamase’s profiles was accomplished using the double disk method. The identification of phylogroups and pathotypes was performed by PCR. Identification of the ESBL genes was performed by sequencing. Results: A total of 26 strains of Escherichia coli (33.0%) were identified from 78 bacterial isolates. Twenty (77.0%) Escherichia coli strains carried extended-spectrum beta-lactamases bla_CTX-M-15 and 5.0% carried bla_SHV-12 subtypes. Phylogroup D (62.0%) was predominant, followed by B1 (12.0%), B2 (8.0%) and E (4.0%). The bacterial pathogens causing diarrhoea were enterohemorrhagic E. coli (12.0%), typical enteropathogenic Escherichia coli (8.0%), atypical enteropathogenic Escherichia coli (4.0%), Enteroaggregative Escherichia coli (4.0%) and enteroinvasive E. coli (4.0%). Conclusions: This study showed a high prevalence of extended-spectrum beta-lactamase, Escherichia coli of phylogroup D and pathotype enterohemorrhagic Escherichia coli in children under 5 years old in public hospitals in Franceville, most probably due to the misuse or inappropriate consumption of beta-lactams.

Background: In Central Africa, it is difficult to fight against antibiotic resistance, because of a lack of data and information on bacterial resistance, due to the low number of studies carried out in the field. To fill this gap, we carried out a systematic review of the various studies, and devise a molecular epidemiology of antimicrobial resistance from humans, animals and the environmental samples.Method: A systematic search of all publications from 2005 to 2020 on bacterial resistance in Central Africa was performed on Pubmed, Google scholar and African journals online. All circulating resistance genes, prevalence and genetic carriers of these resistances were collected. The study area was limited to the 9 countries of Central Africa. Results: Five hundred seventeen studies were identified through a literature search, and sixty studies carried out in 8 countries were included. Among all articles included, 43 articles were from human. Our study revealed not only the circulation of beta-lactamase and carbapenemase genes, but also several other types of resistance genes. To finish, we noticed that some studies reported mobile genetic elements such as integrons, transposons, plasmids, or chromosomes.Conclusion: The scarcity of data poses difficulties in the implementation of effective strategies in the fight against antibiotic resistance, which requires a health policy in a "One Health" approach.