Carriage of multidrug-resistant organisms among patients and healthcare workers in haemodialysis units in public hospitals in Yaounde, Cameroon
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Abstract
Background: The emergence and spread of Multidrug-resistant organisms (MDRO) represent a major public health issue, particularly amongst patients in haemodialysis units. Haemodialysis units regularly receive patients with renal failure, yet almost all hospitals in Cameroon with haemodialysis units lack a resistance surveillance program. The lack of data on the epidemiology of MDRO in haemodialysis units led us to conduct this study, with the aim of determining the frequency of MDRO carriage among patients and healthcare workers in haemodialysis units in Cameroon.
Methods: Nasal and rectal swabs were collected from patients and healthcare staff in two referral hospitals of Yaounde, between November 2023 and April 2024. Bacteria isolated on selective media were identified by biochemical tests and mass spectrometry. Antibiotic resistance profiles and resistance phenotypes were detected according to EUCAST/CASFM 2023 recommendations.
Results: A total of 155 participants were selected, including 130 patients and 25 staff members. Several comorbidities were identified among the patients, including cardiovascular diseases and infections. From the 275 samples collected we isolated 59 (21.45%) MDRO with 54 (91.2%) from patients and 5 (8.48%) from healthcare personnel. Methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), third-generation cephalosporinase-producing Enterobacteriaceae (3CPE) and extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) were more represented among patients compared to healthcare personnel with no significant difference in the two hospitals. There was no significant difference between the age groups (P=0.438). The resistance profile of MDRO was similar in the two hospitals.
Conclusion: This study revealed a high prevalence of MDRO in the haemodialysis unit, highlighting the need for systematic screening of patients on arrival at the haemodialysis unit and for the strengthening of standard precautions.
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References
I. WHO. (2017). WHO publishes list of bacteria for which new antibiotics are urgently needed. World Health Organisation. Accessed 15 July 2026. https://www.who.int/news/item/27-02-2017-who-publishes-list-of-bacteria-for-which-new-antibiotics-are-urgently-needed/
II. Ntock F, Junette M, Tochie JN, Kona S, Ebongue M, Anaba et al. 2021. Infections à bactéries multirésistantes à l’admission des patients dans un service de réanimation de Douala. La Revue de médecine ; 11 : 1287-1291.
III. Hawi SA, Abdulrahman TR, Mahdi HT. 2024. Molecular Detection of Van A and bap Genes in Staphylococcus Species Isolated from Hemodialysis Patients with Blood Stream Infections. Medical Journal of Babylon, 21(2): 1-9.
IV. Markogiannakis A, Fildisis G, Tsiplakou S, Ikonomidis A, Koutsoukou A, Pournaras S, et al. 2008. Cross-transmission of multidrug-resistant Acinetobacter baumannii clonal strains causing episodes of sepsis in a trauma intensive care unit. Infection Control and Hospital Epidemiology, 29(5): 410 417.
V. Acquier M, De-Precigout V, Delmas Y, Dubois V, M’Zali F, Zabala A et al. 2022. Diagnostic et prise en charge des bactériémies liées au cathéter d’hémodialyse : 10 ans après les dernières recommandations. Néphrologie & Thérapeutique, 18(2): 80-88.
VI. GBD Chronic Kidney Disease Collaboration. 2020. Global, regional, and national burden of chronic kidney disease, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet; 395(10225): 709 733.
VII. Kaze FF, Maimouna M, Beybey AF, Pefura-Yone EW, Balkissou AD, Halle MP et al. 2021. Prevalence and determinants of chronic kidney disease in urban adults’ populations of northern Cameroon. Clinical and Experimental Nephrology, 25(7):718 726.
VIII. Bernasconi E, Cereghetti C, Petignat C, Federli I, Ruef C, Francioli P, et al. 2008. Prévention des infections en hémodialyse. Partie II : Précautions standards au centre d’hémodialyse. Swiss-NOSO, 14(1):1-8.
IX. Diop TM, Mangané M, Almeimoune AA, Dembélé AS, Daou E, Bagayoko A. 2020. Epidemiological, clinical and evolutionary aspects of severe traumatic brain injury in the multipurpose intensive care unit of Gabriel Touré Teaching Hospital. Mali Med;35(3):35-39
X. Gonsu KH, Kouemo SL, Koulla SS, Ndze VN, Toukam M. (2013). Nasal carriage of methicillin resistant Staphylococcus aureus and its antibiotic susceptibility pattern in adult hospitalized patients and medical staff in some hospitals in Cameroon. Journal of Microbiology and Antimicrobials; 5(3): 29-33.
XI. CA-SFM. 2023. Recommandations. Vol 1.0.pp.1-177.
XII. Zoccali C, Mallamaci F, Adamczak M, Bueno de Oliveira R, Massy Ziad A, Sarafidis P et al. 2023. Cardiovascular complications in chronic kidney disease: a review from the European Renal and Cardiovascular Medicine Working Group of the European Renal Association. Cardiovascular Research; 119: 2017–2032.
XIII. CDC. 2024. Chronic Kidney Disease and High Blood Pressure. https://www.cdc.gov/kidney-disease/risk-factors/chronic-kidney-disease-ckd-and-adults-with-high-blood-pressure.html. Accessed 15 July 2026.
XIV. Tobe SW, Bajaj HS, Tangri N; Pham T, Beaudin V, McFarlane P. 2025.Chronic Kidney Disease in Diabetes: A Clinical Practice Guideline. Can J Diabetes 49: 1-28.
XV. Ye Q, Chen X, Zhang J ... 2025. Meta-analysis of risk factors for infection by multi-drug-resistant organisms in intensive care unit patients. Journal of Hospital Infection; 158: 1-10
XVI. Su G, Xu H, Riggi E, He Z, Lu L, Lindholm B et al. 2018. Association of Kidney Function with Infections by Multidrug-Resistant Organisms: An Electronic Medical Record Analysis.SCIENTIfIC REpORtS ; 8:1-9.
XVII. Gonsu KH, Napa TYLG, Lyonga ME, Djiraibe J, Chafa BA, Noubom M et al. 2020. Nasal Carriage of Methicillin-Resistant Staphylococcus aureus in Intensive Care Units of Two University Hospitals in Cameroon. Microbiology Research Journal International, 30 (4):26-33.
XVIII. Oweis AO, Zeyad HN, Alshelleh SA, Alzoubi KH. (2022). Acute Kidney Injury Among Patients with Multi-Drug Resistant Infection: A Study from Jordan. Journal of Multidisciplinary Healthcare, 15 :2759–2766
XIX. Toudji, Akouétévi Gérard, Bouraïma Djeri, Simplice Damintoti Karou, Ségla Tigossou, Yaovi Ameyapoh, et Comlan De Souza. (2017). Prévalence des souches d’entérobactéries productrices de bêta-lactamases à spectre élargi isolées au Togo et de leur sensibilité aux antibiotiques. International Journal of Biological and Chemical Sciences 11, (3): 1165‑77.