Prevalence and factors associated with faecal carriage of extended-spectrum β-lactamase-producing Enterobacterales among peripartum women in the community in Cambodia

Agathe de Lauzanne (1) , Navin Sreng (1) , Elsa Foucaud (2) , Touch Sok (3) , Thida Chon (1) , Chhaily Yem (1) , Veasna Hak (1) , Sothada Heng (1) , Meng Soda (1) , Malika Gouali (4) , Maya Nadimpalli (5) , Malin Inghammar (1, 6) , Mamitina Alain Noah Rabenandrasana (7) , Jean-Marc Collard (7) , Muriel Vray (4, 8) , Simon Le Hello (4) , Alexandra Kerleguer (1) , Patrice Piola (1) , Elisabeth Delarocque-Astagneau (9, 10, 11, 12) , Didier Guillemot (4, 9, 13, 10, 11) , Bich Tram Huynh (4, 9, 13, 10) , Laurence Borand (1) , Birdy Study Group

1 Institut Pasteur du Cambodge
2 Hôpital Jean Verdier [AP-HP]
3 Cambodian Communicable Disease Control Department
4 IP - Institut Pasteur [Paris]
5 Tufts University [Medford]
6 Skane University Hospital [Lund]
7 Institut Pasteur de Madagascar
8 Institut Pasteur de Dakar
9 INSERM - Institut National de la Santé et de la Recherche Médicale
10 Université Paris-Saclay
11 Hôpital Raymond Poincaré [AP-HP]
12 UVSQ Santé - Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil
13 UVSQ - Université de Versailles Saint-Quentin-en-Yvelines

Background In Southeast-Asia, where many conditions associated with dissemination of ESBL-producing Enterobacterales (ESBL-E) in the community are met, data from the community are scarce but show high ESBL-E carriage prevalence. Maternal ESBL-E colonization is considered a risk factor for neonatal colonization, which is the first step towards developing neonatal sepsis. Despite this, ESBL-E carriage prevalence and its risk factors during pregnancy or postpartum remain undefined in Southeast-Asia. Objectives To estimate the prevalence of ESBL-E faecal colonization among peripartum women in the community of an urban and a rural area in Cambodia, to investigate ESBL-E genomic characteristics and to identify associated risk factors. Methods Epidemiological data and faecal samples from 423 peripartum women were collected in an urban and rural areas in Cambodia (2015–16). Bacterial cultures, antibiotic susceptibility tests and ESBL gene sequencing were performed. Risk factor analysis was conducted using logistic regression. Results The prevalence of ESBL-E faecal carriage was 79.2% (95% CI 75.0%–82.8%) among which Escherichia coli (n = 315/335, 94.0%) were most frequent. All isolates were multidrug resistant. Among 318 ESBL-E, the genes most frequently detected were blaCTX-M-15 (41.5%), blaCTX-M-55 (24.8%), and blaCTX-M-27 (15.1%). Low income, undernutrition, multiparity, regular consumption of pork, dried meat, and raw vegetables, were associated with ESBL-E faecal carriage. Conclusions The high prevalence of ESBL-E carriage observed among peripartum women in Southeast-Asia and the identified associated factors underline the urgent need for public health measures to address antimicrobial resistance, including a ‘One Health’ approach.

Domaines: Santé publique et épidémiologie; Bactériologie

Agathe de Lauzanne, Navin Sreng, Elsa Foucaud, Touch Sok, Thida Chon, et al.. Prevalence and factors associated with faecal carriage of extended-spectrum β-lactamase-producing Enterobacterales among peripartum women in the community in Cambodia. Journal of Antimicrobial Chemotherapy, 2022, 77 (10), pp.2658-2666. ⟨10.1093/jac/dkac224⟩. ⟨pasteur-03717304⟩