1. High Fecal Carriage of Antibiotic Resistant Enterobacteriaceae Strains among Food Handlers in the West Coast Region of The Gambia
Bakary Sanneh1*, Olliemattou Sagnia1, Abou Kebbeh1, Haruna S. Jallow1, Ignatius Baldeh1, Sana M. Sambou1, Yaya Camara1, Matheu Alvarez Jorge-Raul2, Antoine Andremont3
1National Public Health Laboratories, Ministry of Health and Social Welfare; University of The Gambia, School of Public Health 2World Health Organization, foodborne department, Geneva 3University Paris-Diderot Medical School, France
Corresponding author: Bakary Sanneh
 Prepared and presented by: Olliemattou Sagnia
Background
The introduction and development of sophisticated antibiotics, has triggered the emergence of multi drug resistance (MDR) among bacterial pathogens, mainly owing to the production of β-lactamase enzymes. Rapidly emerging β-lactamases include diverse ESBL, AmpC β-lactamases, and carbapenem-hydrolyzing β-lactamases. Studies have shown Klebsiella pneumoniae and Escherichia coli to be the most common producers of resistant genes. Limited discovery of antibiotics makes this phenomenon a major public health threat. The study evaluated the fecal carriage rate of multidrug resistant Enterobacteriaceae strains among food handlers.
Fig. 1 Field worker administering a questionnaire
Fig. 2 Lab scientists culturing samples on drigalski agar
Methods
600 participants were enrolled but only 565 participants with complete data set were selected
Stool samples were homogenized in enrichment media (peptone water) and streaked on chromogenic agar (Drigalski agar & 2mg cefotaxime) to screen for resistance.
Bacterial susceptibility of isolates to other classes of antibiotics was determined by double disk diffusion method.
Resistant strains were identified using Api 20E system
Data was analyzed using SPSS and Epi Info.
Fig. 4 ESBL isolates confirmatory tests
Fig. 2 Sample in peptone water prior to culturing
Results
Prevalence rate of MDR was measured at 15.8%
Prevalence was highest in the cosmopolitan district of KMC (49.44%)
23 genuses and 89 species of resistant strains were isolated.
Majority of the identified strains were Enterobacter aerogene (13.5%), Klebsiella pneumoniea (13.5%) and Escherichia coli (9%)
ESBL, AmpC and carbapenemase production was 20.22%, 46.07% and 15.17%, respectively.
Discussion
The study confirms the presence of MDR Enterobacteriaceae strains among carriers in the country and in the subregion
K. pneumoniae and E. coli were among the most dominant strains which studies confirm to be the main causative agents of UTI. E. aerogenes strains were also dominant though intrinsically resistant
Isolation of highly multi resistant Salmonella among food handlers poses a great threat to the food industry
Fig. 6 Antibiotic Resistance Pattern (%)
Fig. 7 Resistance pattern of isolates (%)
Conclusion
The study concludes that the high burden of MDR among food handlers is associated with irrational use of antibiotics, bad health seeking behaviors and lack of food safety knowledge. Therefore there is need to screen and educate food handlers on food safety measures.
References
CLSI-2015; ACMFS
Acknowledgement
WHO, MOH&SW, MoBSE, participants, field workers and team members
2nd UNESCO-Merck Africa Research Summit_28th – 29th November 2016_Addis Ababa, Ethiopia.