RESUMEN
OBJECTIVES: To assess antibiotic susceptibility of community-acquired respiratory tract isolates from Ivory Coast, Kenya, Democratic Republic of Congo (DRC) and Senegal in 2011-14. METHODS: Bacterial isolates were collected and MICs determined using Etest(®) for all antibiotics except erythromycin, for which testing was by disc diffusion. Susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. For macrolide interpretation, CLSI breakpoints were adjusted for incubation in CO2. RESULTS: Susceptibility to penicillin (using CLSI oral or EUCAST breakpoints) was low among isolates of Streptococcus pneumoniae from the DRC and Kenya (17.4% and 19%, respectively) but higher among isolates from the Ivory Coast (70%) and Senegal (85.7%). Penicillin susceptibility using CLSI iv breakpoints was higher in all countries, but still only 69.6% in the DRC. Macrolide susceptibility (based on CLSI erythromycin disc diffusion breakpoints) was also low in Kenya (â¼65%) but 87%-100% elsewhere. Haemophilus influenzae were only collected in the DRC and Senegal, with ß-lactamase prevalence of 39% and 4%, respectively. Furthermore, ß-lactamase-negative ampicillin-resistant (BLNAR) isolates were found in DRC (four isolates, 17%), but only two isolates were found in Senegal (by EUCAST definition). Amoxicillin/clavulanic acid in vitro susceptibility was 73.9% in the DRC and 100% in Senegal based on CLSI breakpoints, but this reduced to 65.2% in the DRC when BLNAR rates were considered. Clarithromycin susceptibility was >95% in both countries. CONCLUSIONS: There was considerable variability in antibiotic susceptibility among the African countries participating in the surveillance programme. Thus, continued surveillance is necessary to track future changes in antibiotic resistance. Use of EUCAST versus CLSI breakpoints showed profound differences for cefaclor and ofloxacin against S. pneumoniae, with EUCAST showing lower susceptibility.
Asunto(s)
Antibacterianos/farmacología , Infecciones Comunitarias Adquiridas/microbiología , Farmacorresistencia Bacteriana , Haemophilus influenzae/efectos de los fármacos , Infecciones del Sistema Respiratorio/microbiología , Streptococcus pneumoniae/efectos de los fármacos , Adolescente , Adulto , África/epidemiología , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Infecciones Comunitarias Adquiridas/epidemiología , Monitoreo Epidemiológico , Femenino , Haemophilus influenzae/aislamiento & purificación , Humanos , Lactante , Recién Nacido , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Infecciones del Sistema Respiratorio/epidemiología , Streptococcus pneumoniae/aislamiento & purificación , Adulto JovenRESUMEN
The aim of the study was to show the emergence of the qnr genes in extended spectrum beta-lactamases producing enterobacteria in Abidjan between 2005 and 2006. The whole of 151 strains of extended spectrum beta-lactamases producing enterobacteria were studied: 64 Escherichia coli, 66 Klebsiella pneumoniae, seven Klebsiella oxytoca and 14 Enterobacter spp. isolated from various biological products and from in- and out-patients. The techniques of disks diffusion, double-disk synergy, E-test were respectively used for the antimicrobial susceptibility test, the detection of extended spectrum beta-lactamases and the minimal inhibiting concentration. The bla genes(SHV, TEM, CTXM groups 1, 2, 8, 9), and AmpC were determined by PCR and characterized by sequencing. A global prevalence of 27,2 % (41/151) and rates of 9,9, 14,6, 2,7 % for the qnr genes A, B, A and S were observed. The distribution was 42,9 % for Enterobacter spp, 31,2 % for Escherichia coli, 20,5 % for Klebsiella; 30 strains expressed at least two bla genes; four strains were associated with AmpC. The strains were resistant to the cotrimoxazole (97,6 %), to the céfépime (73,2 %), to the céfoxitine (56,1 %), to the imipénème (0 %) and 43,9 % to all the aminosides. This high qnr gene prevalence associated with several types of bla genes in epidemic matter, the high level of resistance to antibiotics make fear a high risk of the transmission of multi-resistants bacteria and challenge the authorities for a resistance monitoring policy.
Asunto(s)
Proteínas Bacterianas/análisis , Infecciones por Enterobacteriaceae/microbiología , Enterobacteriaceae/efectos de los fármacos , Quinolonas/farmacología , beta-Lactamasas/análisis , Líquidos Corporales/microbiología , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/microbiología , Côte d'Ivoire/epidemiología , Infección Hospitalaria/epidemiología , Infección Hospitalaria/microbiología , ADN Bacteriano/genética , Farmacorresistencia Bacteriana Múltiple/genética , Enterobacteriaceae/clasificación , Enterobacteriaceae/enzimología , Enterobacteriaceae/genética , Infecciones por Enterobacteriaceae/epidemiología , Genes Bacterianos , Humanos , Reacción en Cadena de la Polimerasa , Especificidad de la Especie , Especificidad por Sustrato , Resistencia betalactámica/genéticaRESUMEN
BACKGROUND: Acute otitis media (AOM) is the commonest infectious disease of childhood. Its treatment is based on a probabilistic antibiotic therapy. OBJECTIVE: To determine the prevalence of different bacteria responsible for AOM in children in Abidjan (Côte d'Ivoire). MATERIALS AND METHODS: This is a prospective study, between November 2002 and August 2003. To identify bacterial isolates, 60 children under 15 years old with AOM were enrolled. In 52 cases, the sample was recovered by aspiration of a spontaneous otorrhea and in eight cases, it was taken by paracentesis. Nasopharyngeal swabs were cultured. Antibiotic susceptibility tests were performed on isolates. RESULTS: 75% of children were under 24 months of age. Pseudomonas aeruginosa was recovered in 31.8% of cases followed by Streptococcus pneumoniae (21%), Proteus (7.4%) and Staphylococcus (6.2%). The rate of penicillin-nonsusceptible S. pneumoniae (NSSP) was 11.8%. Resistance to erythromycin was 6%. For Pseudomonas, resistances to antibiotics were 35.5% to ceftazidim and 16% to pefloxacin, respectively, but all the strains were sensible to colistin, iminepem and ciprofloxacin. CONCLUSION: These data can modify therapeutic approaches for treatment of AOM in our country. This study should encourage surveillance of AOM microbiology.
Asunto(s)
Otitis Media/microbiología , Enfermedad Aguda , Adolescente , Factores de Edad , Antibacterianos/uso terapéutico , Niño , Preescolar , Côte d'Ivoire/epidemiología , Farmacorresistencia Bacteriana Múltiple , Femenino , Bacterias Gramnegativas/aislamiento & purificación , Bacterias Grampositivas/aislamiento & purificación , Vacunas contra Haemophilus , Humanos , Lactante , Masculino , Otitis Media/tratamiento farmacológico , Otitis Media/epidemiología , Vacunas Neumococicas , Estudios Prospectivos , Factores de Riesgo , Factores SexualesRESUMEN
From 313 samples of CSF, urine, sera and pleural liquid, the authors show how appreciable is the contribution in research of soluble antigens by sensibilized latex particles agglutination method in etiologic diagnosis, especially during meningitis, pulmonary and neonatal infections. Soluble antigens were declared positives in 62.26% of cases against S. pneumoniae, 25.4% of cases against H. influenzae, 6.66% of cases against S. agalactiae, 5.71% of cases against N. meningitidis C, with variable percentages from one biological liquid to another. Compared to classical bacteriologic techniques, this method allows the diagnosis of an infection even when decapitated, and could be used in emergency diagnosis.