Prevalence and Associated Risk Factors of Fecal Carriage of Multidrug-resistant Enterobacteriaceae in a Community Setting in Touboro, Northern Cameroon
Karyom Djim-Adjim-Ngana *
Department of Tropical Medicine and Infectious Diseases, School of Health and Medical Sciences, Kesmonds International University, Ngaoundere, Cameroon, Laboratory of Microbiology, Infectious Diseases, and Immunology, Centre for Research on Health and Priority Pathologies, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Cameroon, Department of Biomedical Sciences, Faculty of Sciences, University of Ngaoundere, Cameroon and Department of Veterinary Public Health, School of Veterinary Medicine and Sciences, University of Ngaoundere, Ngaoundere, Cameroon.
Talom Tangue Benjamin
Department of Biomedical Sciences, Faculty of Sciences, University of Ngaoundere, Cameroon.
Djamilatou Iyaganama
Department of Biomedical Sciences, Faculty of Sciences, University of Ngaoundere, Cameroon and Bacteriology Unit, Clinical Biology Laboratory, Regional Hospital Centre of Garoua, Garoua, Cameroon.
Medeme Mbezele Gisèle Larissa
Laboratory of Microbiology, Infectious Diseases, and Immunology, Centre for Research on Health and Priority Pathologies, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Cameroon.
Maina Toumpim
Bacteriology Unit, Clinical Biology Laboratory, Regional Hospital Centre of Garoua, Garoua, Cameroon.
Ibrahima Djoulde
Department of Tropical Medicine and Infectious Diseases, School of Health and Medical Sciences, Kesmonds International University, Ngaoundere, Cameroon and Laboratory of Microbiology, Infectious Diseases, and Immunology, Centre for Research on Health and Priority Pathologies, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Cameroon.
Larissa Nsuh
Department of Tropical Medicine and Infectious Diseases, School of Health and Medical Sciences, Kesmonds International University, Ngaoundere, Cameroon.
Ebogo Belobo Jean Thierry
Laboratory of Microbiology, Infectious Diseases, and Immunology, Centre for Research on Health and Priority Pathologies, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Cameroon.
Cedric Fossi Tchinda
Pharmacology and Drugs Discovery Laboratory, Centre for Research on Medicinal Plants and Traditional Medicine, Institute of Medical Research and Medicinal Plants Studies, Ministry of Scientific Research and Innovation, Ministry of Scientific Research and Innovation, Cameroon.
Lucia Nkengazong
Laboratory of Microbiology, Infectious Diseases, and Immunology, Centre for Research on Health and Priority Pathologies, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Cameroon.
Fodouop Chegaing Siméon Pierre
Department of Biomedical Sciences, Faculty of Sciences, University of Ngaoundere, Cameroon.
Asakizi Augustine Nji
Department of Biological Sciences, University of Bamenda, Ministry of Higher Education, Bamenda, Cameroon.
Atanga Desmond Funwie
Department of Epidemiology and Biostatistics, School of Health and Medical Sciences, Kesmonds International University, Ngaoundere, Cameroon.
Akah Roland Tiagha
Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Buea, Buea, Cameroon.
Richard Tagne Simo *
Department of Biomedical Sciences, Faculty of Sciences, University of Ngaoundere, Cameroon.
*Author to whom correspondence should be addressed.
Abstract
Background: This study reports a high prevalence of intestinal carriage of multidrug-resistant Enterobacteriaceae (MDR-E) in the rural district of Touboro in Northern Cameroon.
Methodology: A community-based cross-sectional study was conducted from May 29 to December 30, 2024. Fecal samples were collected and processed using standard microbiological methods for bacterial isolation and identification. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion method in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines. Data were analyzed using R software, and a p < 0.05 was considered statistically significant. Bivariate analyses were performed to identify potential risk factors associated with MDR-E carriage.
Results: Among the 470 fecal samples analyzed, 161 Enterobacteriaceae isolates were recovered. E. coli was the most prevalent species, accounting for 68.3% (110/161) of isolates, followed by E. cloacae (16.1%) and K. pneumoniae (15.5%). Of these, 83 isolates were identified as multidrug-resistant, corresponding to an overall MDR-E prevalence of 17.7% in the study population and 51.6% among the isolates. The MDR isolates exhibited extremely high resistance rates to ampicillin and cefixime (100% each). High resistance was also observed to other β-lactams, including ceftazidime (90.4%), ceftriaxone (89.2%), cefotaxime (80.7%), cefepime (86.7%), amoxicillin–clavulanic acid (83.1%), and cefoxitin (79.5%). Resistance to quinolones and fluoroquinolones was similarly high, particularly norfloxacin (84.3%), ciprofloxacin (83.1%), and nalidixic acid (79.5%). Lower resistance rates were observed for chloramphenicol (49.4%), aztreonam (55.4%), meropenem (45.8%), trimethoprim–sulfamethoxazole (48.2%), amikacin (68.7%), and nitrofurantoin (68.7%). Multiple antibiotic resistance (MAR) index analysis revealed that 35.0% of the isolates had a MAR index ≥ 0.6, indicating substantial antibiotic selection pressure. Bivariate analysis showed that male sex, marital status, Hospitalization (previous year), lack of recent antibiotic use, residence in livestock areas, and non-consumption of wild animals were significantly associated with MDR-E carriage.
Conclusion: This study demonstrates a high burden of intestinal carriage of multidrug-resistant Enterobacteriaceae in a rural community of Northern Cameroon, reflecting intense antimicrobial pressure and potential community-level transmission. These findings underscore the urgent need for One Health oriented surveillance, rational antibiotic use, and targeted public health interventions to limit the spread of antimicrobial resistance in community settings.
Keywords: Enterobacteriaceae, intestinal carriage, multidrug resistance, Associated Risk Factors, Touboro, Northern Cameroon