Comparative Analysis of Antimicrobial Resistance Profiles in Enterobacteriaceae Isolates From Outpatient Carriages and Clinical Infections in an Urban Setting.

Authors

Kobina Amandzé Adams Kofi, Stéphane Kouadio Koffi, Mathieu Kra Adou Koffi, Alexia Yapi Ivan, N Guessan Carole Obouayeba Djaman, Aboubacar Bamba, Flora Ahonzo, Kacou N Douba Adèle

Published in

BioMed research international. Volume 2026. Issue 1. Pages e8393896.

Abstract

The emergence and spread of multidrug-resistant Enterobacteriaceae (MDR-E) in community and hospital settings constitute a major public health challenge, particularly in densely populated urban areas. Although antimicrobial resistance among clinical isolates has been repeatedly studied, resistance profiles of intestinal carriage strains remain scarcely reported, despite their potential role as important reservoirs of resistance genes. An integrated approach including both carriage and clinical isolates is therefore necessary to better understand antimicrobial resistance dynamics.
This study is aimed at comparing the antibiotic resistance profiles of Enterobacteriaceae isolated from intestinal carriage in outpatients and those from clinical infections.
A total of 196 strains, including Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae, were analyzed, comprising 60 carriage isolates and 136 clinical isolates. Antimicrobial susceptibility testing was performed using the disk diffusion method according to CA-SFM guidelines. Resistance profiles were classified as multidrug-resistant (MDR), extensively drug-resistant (XDR), or pandrug-resistant (PDR) based on the criteria of Magiorakos et al., and the multiple antibiotic resistance (MAR) index was calculated.
Overall, a high prevalence of MDR strains was observed (86.73%) in both groups, with distinct resistance patterns depending on the source. Carriage strains showed higher resistance to cephalosporins, fluoroquinolones, monobactams, tetracyclines, and sulfonamides (MAR index: 0.76 ± 0.09), whereas clinical strains exhibited increased resistance to aminoglycosides and carbapenems (MAR index: 0.65 ± 0.18). XDR (6.12%) and PDR (1.02%) phenotypes were mainly identified among clinical isolates.
These findings emphasize the role of intestinal carriage as a reservoir of antimicrobial resistance and support the need for integrated community-hospital surveillance strategies in urban settings.

PMID:
42583909
Bibliographic data and abstract were imported from PubMed on 12 Aug 2026.

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