[1]Gbégbé, D. A., 1,2N’zi, N. P., 3Monthaut, S., 2Guessennd-Kouadio, N., and *1Angaman, D. M.
1Department of Biochemistry-Microbiology, Jean Lorougnon Guédé University, Daloa, P.O. Box 150 Daloa, Côte d’Ivoire
2Department of Bacteriology-Virology, National Reference Center for Antibiotics, Pasteur Institute Côte d’Ivoire, P. O. Box 490 Abidjan 01, Côte d’Ivoire
3Bacteriology-Virology Laboratory, Regional Hospital Center of Daloa, P. O. Box 207 Daloa, Côte d’Ivoire *Correspondence to: angaman@ujlg.edu.ci
Abstract:
Background: The escalating issue of bacterial resistance is a profound universal peril. This looming crisis has evolved from a mere forecast to a tangible reality globally. Urinary tract infections (UTIs) significantly influence antibiotic prescriptions in primary care, thus crucially impacting the selective pressure and the emergence of antibiotic-resistant bacteria. A profound comprehension of the microorganisms involved in UTIs and their resistance patterns is crucial, particularly in Daloa city, Côte d’Ivoire. This research aims to review the antibiotic resistance profiles of uropathogens isolated from patients in the Regional Hospital Center (CHR) of Daloa, Côte d’Ivoire from January 2019 to December 2022.
Methodology: This was a descriptive cross-sectional study of 1,513 patients whose voided urine samples were received at the Bacteriology-Virology Laboratory of CHR for cyto-bacteriological examination and aerobic culture using standard microbiological protocols over a period of 4 years. Bacterial isolates were routinely identified by colony morphology, Gram staining reaction and conventional biochemical tests. The antibiotic susceptibility of the bacterial isolates was determined by the agar diffusion method and interpreted following the Antibiogram Committee of the French Society of Microbiology (CASFM) guidelines.
Results: Of the 1,513 patient urine samples examined, 246 (16.3%) were positive for microbial organisms, 216 (14.3%) were positive for significant bacterial isolates, 9 (0.6%) were positive for fungi, and 21 (1.4%) were positive for ova of Schistosoma haematobium. Among the samples with significant bacteriuria, 91.2% were due to Gram-negative bacilli, 5.9% to Gram-positive cocci, and 2.9% to Gram-negative cocci. Escherichia coli was the most predominant bacterial pathogen, accounting for 73.2% of the isolates. Antibiotic susceptibility testing showed high in vitro resistance of the bacterial isolates to tested antibiotics, with Enterobacteriaceae exhibiting resistance rate between 56.0% for nalidixic acid (NAL) and 67.0% for amoxicillin/clavulanic acid (AMC). Pseudomonas aeruginosa isolates exhibited 50.0% resistance rate to ceftazidime (CAZ), ciprofloxacin (CIP), and ticarcillin (TIC) while Staphylococcus isolates demonstrated 100.0% resistance rate to ofloxacin (OFX), clindamycin (CMN), erythromycin, trimethoprim/sulfamethoxazole (SXT), and fusidic acid (FA). The extendedspectrum beta-lactamase (ESBL)-producing isolates were identified in 15.1% of the Enterobacteriaceae.
Conclusion: The high prevalence of antibiotic resistant bacterial isolates from significant bacteriuria in our study highlights the pressing need for the formulation and implementation of strategies to address this potential public health menace. The findings of our study may be useful for healthcare authorities to plan strategic interventions that will assist in optimizing the management of bacteriuria and UTI in the city of Daloa.
Keywords: Urinary tract infection, bacterial resistance, antibiotic, ESBL, Enterobacteriaceae
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