{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T13:46:33Z","timestamp":1787579193005,"version":"build-2736575974"},"reference-count":56,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n \n The increasing prevalence of \u03b2-lactamase-producing\n Escherichia coli<\/jats:italic>\n and\n Klebsiella pneumoniae<\/jats:italic>\n in community-acquired urinary tract infections (CA-UTIs) represents a growing public health challenge in low-resource settings. Data from Central Africa remain limited. This study investigated antimicrobial resistance profiles and phylogenetic diversity of these pathogens in southeastern Gabon.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Patients presenting with CA-UTIs were screened, and isolates of\n E. coli<\/jats:italic>\n and\n K. pneumoniae<\/jats:italic>\n were collected. Antimicrobial susceptibility testing was performed using the Kirby\u2013Bauer disk diffusion method and interpreted according to EUCAST 2024 guidelines. Phenotypic screening identified extended-spectrum \u03b2-lactamase (ESBL), AmpC, and carbapenemase production. Polymerase chain reaction (PCR) was used to detect ESBL genes (\n bla-<\/jats:italic>\n CTX-M-gp1<\/jats:italic>\n , bla-<\/jats:italic>\n CTX-M-gp2<\/jats:italic>\n , bla-<\/jats:italic>\n CTX-M-gp9<\/jats:italic>\n , bla-<\/jats:italic>\n TEM<\/jats:italic>\n , bla-<\/jats:italic>\n SHV<\/jats:italic>\n ), plasmid-mediated AmpC genes (\n bla-<\/jats:italic>\n CMY-1<\/jats:italic>\n , bla-<\/jats:italic>\n CMY-2<\/jats:italic>\n , bla-<\/jats:italic>\n ACT-1<\/jats:italic>\n , bla-<\/jats:italic>\n ACC<\/jats:italic>\n , bla-<\/jats:italic>\n FOX<\/jats:italic>\n , bla-<\/jats:italic>\n DHA<\/jats:italic>\n ), and the carbapenemase gene\n bla-OXA-48<\/jats:italic>\n . Phylogenetic grouping of ESBL-producing\n E. coli<\/jats:italic>\n was determined using PCR targeting\n chuA, yjaA, Tsp<\/jats:italic>\n E4.C2, and\n arpA.<\/jats:italic>\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 3,026 screened patients, 949 CA-UTIs were confirmed, including 589 cystitis and 360 pyelonephritis cases, yielding 200 isolates:\n E. coli<\/jats:italic>\n (124) and\n K. pneumoniae<\/jats:italic>\n (76). Of these, 68 (34.0%) were ESBL producers, 17 (9.0%) AmpC producers, and 2 (1.0%) carbapenemase producers. ESBL producing isolates were significantly associated with male sex (47.0%, p\u2009=\u20090.02) and children \u22645 years of age (48.2%, p\u2009=\u20090.007). ESBL- and AmpC-producing isolates exhibited high resistance rates (20\u2013100%) to \u03b2-lactams, fluoroquinolones, and trimethoprim\u2013sulfamethoxazole, while retaining susceptibility to carbapenems, ceftazidime\u2013avibactam, and nitrofurantoin (up to 100%). Molecular analysis showed predominance of\n bla-<\/jats:italic>\n CTX-M-gp1 in\n E. coli<\/jats:italic>\n (40% alone; 31% in combination with\n bla-<\/jats:italic>\n TEM<\/jats:italic>\n ). In\n K. pneumoniae, bla-<\/jats:italic>\n SHV<\/jats:italic>\n \u2009\n +\u2009bla-<\/jats:italic>\n TEM<\/jats:italic>\n (49%) and\n bla-<\/jats:italic>\n SHV<\/jats:italic>\n \u2009\n +\u2009bla-<\/jats:italic>\n CTX-M-gp1<\/jats:italic>\n \u2009+\u2009\n bla-<\/jats:italic>\n TEM<\/jats:italic>\n (42%) were the most frequent gene combinations; one isolate carried\n bla-<\/jats:italic>\n OXA-48<\/jats:italic>\n . ESBL-producing\n E. coli<\/jats:italic>\n predominantly belonged to phylogroup A (48.6%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Multidrug-resistant ESBL-, AmpC-, and OXA-48-producing\n E. coli<\/jats:italic>\n and\n K. pneumoniae<\/jats:italic>\n are circulating in community settings in southeastern Gabon. These findings underscore the need for strengthened antimicrobial resistance surveillance and evidence-based community-level interventions.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0343632","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T18:23:01Z","timestamp":1771957381000},"page":"e0343632","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["High burden and genetic diversity of \u03b2-lactamase-producing Escherichia coli and Klebsiella pneumoniae causing community-acquired urinary tract infections in Southeastern Gabon"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1280-1211","authenticated-orcid":true,"given":"Yann","family":"Mouanga-Ndzime","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrille","family":"Bisseye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annicet-Clotaire","family":"Dikoumba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00e9sir\u00e9 Otsaghe","family":"Ekore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Bignoumba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Louise Mawili","family":"Mounguengui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil-Michel","family":"Longo-Pendy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Godreuil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barth\u00e9l\u00e9my","family":"Ngoubangoye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bolni Marius","family":"Nagalo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Onanga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"issue":"1","key":"pone.0343632.ref001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ucl.2007.09.004","article-title":"Uncomplicated urinary tract infection in adults including uncomplicated pyelonephritis","volume":"35","author":"LE Nicolle","year":"2008","journal-title":"Urol Clin North Am"},{"issue":"5","key":"pone.0343632.ref002","first-page":"237","article-title":"Antimicrobial resistance: global report on surveillance 2014","volume":"7","author":"PR Shankar","year":"2014","journal-title":"Australas Med J 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