Perceived stress at work is an important risk factor that affects the mental and physical health of workers. This study aims to determine the prevalence and factors associated with perceived stress in the informal electronic and electrical equipment waste processing sector in French-speaking West Africa. From 14 to 21 November 2019, a cross-sectional survey was carried out among e-waste workers in five countries in the French-speaking West African region, and participants were selected by stratified random sampling. Participants were interviewed on socio-demographic variables and characteristics related to e-waste management activities using a questionnaire incorporating Cohen’s Perceived Stress Scale (10-item version). Factors associated with perceived stress were determined by multivariate logistic regression. A total of 740 e-waste workers were interviewed. The mean age of the workers was 34.59 ± 11.65 years, with extremes of 14 and 74 years. Most of the interviewees were repairers (43.11%). The prevalence of perceived stress among the e-waste workers was 76.76%. Insufficient income, number of working days per week, perceived violence at work, and the interference of work with family responsibilities or leisure were the risk factors that were the most associated with perceived stress. The high prevalence of perceived stress and its associated factors call for consideration and improvement of the working conditions of e-waste workers.

Background: Citrobacter freundii is an emerging nosocomial pathogen, yet its transmission dynamics remain poorly characterized. Methods: We conducted a retrospective genomic and epidemiological study to investigate the transmission chains of extended-spectrum beta-lactamase (ESBL) and carbapenemase-producing C. freundii collected at Geneva University Hospitals during a 6-year period (2017–2022). Whole-genome sequencing (WGS) using Nanopore long-read sequencing, MLST and plasmid typing, and resistome profiling were performed. Transmission events were defined based on genetic relatedness, plasmid similarity and patient trajectories. Results: A total of 103 cases of ESBL and carbapenemase-producing C. freundii were identified, of which 79% were hospital-acquired, 72% were isolated from rectal swabs, and bacteremia occurred in 6 patients. Among 90 isolates available for WGS, 73% were confirmed as C. freundii, whereas the remaining belonged to other Citrobacter species. A high genetic diversity was observed among C. freundii sensu stricto, with 29 distinct sequence types, including predominant ST114, ST98, and ST22. We identified 10 clusters involving multiple Citrobacter species among 35 patients, with a median cluster duration of 103 weeks (IQR, 65–138). Transmission chain analysis revealed that 37% of patients were involved in putative clonal transmission and 21% in putative plasmid-mediated dissemination events, particularly in abdominal surgery, geriatrics and septic orthopedics, often involving C. freundii harboring blaCTX-M-15, blaOXA-48/CTX-M-14b, and blaOXA-181 on IncHI2-IncHI2A, IncM1, and IncX3 plasmids, respectively. Conclusions: Our study highlights the role of C. freundii as a vector of both clonal and plasmid-mediated, nosocomial transmission of antimicrobial resistance. It emphasizes the need to include C. freundii in genomic and epidemiological surveillance to detect its silent spread.