High prevalence of antibiotic resistant Campylobacter among patients attending clinical settings in Kigali, Rwanda.

Abstract

Background: Thermophilic Campylobacter species are important causes of human gastroenteritis and inappropriate use of antimicrobials has led to the emergence of antimicrobial resistance (AMR). In Rwanda, data is limited on the prevalence and AMR carriage rate of Campylobacter strains. This study aimed at assessing the prevalence and antimicrobial susceptibility profiles of Campylobacter species among isolates obtained from different clinical settings in Kigali city, Rwanda.

Methods: This cross-sectional study used a purposive sampling method to collect 385 stool samples from consenting patients attending the Microbiology Department at Kigali University Teaching Hospital (CHUK), Nyarugenge District Hospital, Muhima and Biryogo Health Centers (HC). Campylobacter species were isolated using culture and characterized with biochemical tests and multiplex Polymerase Chain Reaction (PCR) for species confirmation. Antimicrobial susceptibility testing (AST) with six antimicrobials [ciprofloxacin (CIP), tetracycline (TET), chloramphenicol (CHL), streptomycin (STR), erythromycin (ERY), and gentamicin (GEN)] was carried out by using Kirby-Bauer disk diffusion.

Results: The overall prevalence of Campylobacter spp. was 7.0% (27/385) and the highest prevalence of 77.8% (21/27) was recorded at Biryogo HC. The prevalence of C. jejuni and C. coli were 92.6% (25/27) and 7.4% (2/27), respectively. Infection was significantly associated with diarrhea (p < 0.0001). Campylobacter isolates showed high resistance to STR (85.2%, 23/27), followed by ERY (66.7%, 18/27), and CIP (37.1%, 10/27). The isolates were sensitive to CHL at 88.9% (24/27), TET at 66.7% (18/27), and GEN at 66.7% (18/27).

Conclusion: The prevalence of campylobacteriosis in Kigali City is not negligible and is associated with diarrhea. Campylobacter strains isolated from clinical settings were resistant to commonly used antimicrobials. Larger studies will provide insights into the national status of Campylobacter-related AMR. Routine monitoring of antimicrobial use is recommended to mitigate this public health threat. Molecular analyses of resistant strains are warranted to characterize the genomic drive of antibiotic resistance.