Molecular characterization of Plasmid-Mediated Quinolone Resistance (PMQR) and Extended-Spectrum β-Lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae isolated from Urinary Tract Infections (UTIs) among patients living with Sickle Cell Diseases (SCD) in Yaoundé, Cameroon

Background Extended-spectrum β-lactamase producing- E. coli (ESBL- Ec ) and K. pneumoniae (ESBL- Kp ) are pathogens of critical priority that urgently required research and development of new antibiotics. Fluoroquinolones are broad-spectrum antibiotics commonly used to treat urinary tract infections (UTIs) among patients living with sickle cell disease (SCD). This study aims at determining the prevalence, phenotypic and genotypic characterizatics of plasmid-mediated quinolone resistance genes among ESBL- Ec and ESBL- Kp isolated from SCD patients with UTIs in Yaoundé, Cameroon. Methods A cross-sectional study was conducted in two healthcare facilities from February to June, 2024. Mid-stream urine samples were collected from UTI patients living with SCD. ESBL- Ec and ESBL- Kp isolates were biochemical identified using API20E following the manufacturer’s instructions. The antimicrobial susceptibility test was performed using the Kirby-Bauer disk diffusion method. ESBL-phenotype was screened using the double-disk synergy test and confirm by plating onto ChromAgar™ ESBL medium. Antimicrobial resistance genes were detected using polymerase chain reaction methods. The data analysis was performed using Excel 2016 and IBM SPSS version 20. Results A total of 90 urine samples were collected and analysed during the study period. The prevalences of Escherichia coli and Klebsiella pneumoniae were 7,7% (7/90) and 10% (10/90) respectively. Among these, the rate of ESBL production was 57,14% (4/7) for E. coli and 60% (6/10) for Klebsiella pneumoniae . The prevalences of ciprofloxacin non-susceptible among ESBL- Ec and ESBL- Kp were 12,5% (1/8) and 87,5% (7/8) respectively. High antimicrobial resistance rate was observed for amoxicillin, amoxicillin + clavulanic acid, ceftazidime, thrimethoprim, pefloxacin. The most common resistance genes detected encoding for β-lactam and fluoroquinolone resistance were bla _CTX−M , oqx A, bla _TEM , qnr S respectively. Conclusion The findings revealed a high burden of fluoroquinolone resistance in ESBL- Ec and ESBL- Kp among SCD patients with UTIs. This study emphasizes the necessity for monitoring and surveillance of resistant strains against β-lactam and fluoroquinolone antibiotics among this vulnerable population. It is thus crucial to implement antimicrobial stewardship programs at the local and national levels and develop the appropriate protocols for antibiotic usage in these healthcare facilities to curb the emergence and escalation of these growing resistant bacteria.