Status of resistance to antimicrobial agents of Staphylococcus aureus strains at the laboratory of microbiology of the HU-JRA Antananarivo

A.M. Andrianarivelo, T.H. Andriamandimbisoa, L.M. Rakotondraoelina, A.B.A. Ratsimbazafy, F.E. Razafimanantsoa, A.A. Raharisoa, C Rafalimanana, A Rasamindrakotroka

 

Abstract

Introduction: On contact of antibiotics, S. aureus has gradually acquired multiple antibiotic resistances, including the methicillin (MRSA) and without lose its virulence. The aim of the present study was to report the evolution of resistance of S. aureus to different common antibiotics and to determine the antibiotics active against MRSA.

Materials and methods: This is a retrospective and descriptive study for 10 years from January 2005 to December 2014 at the Laboratory of Microbiology of the HU-JRA Antananarivo, the biggest academic hospital located in the capital of Madagascar. All demands for standard bacteriological examination were registered in the laboratory for various bacteriological exams or from samples taken from hospitalized patients and we included all positive cultures for S. aureus. The variables selected and used for the study were community or nosocomial sources of patients and results of susceptibility testing.

Results: A total of 906 results from 282 (31.12%) community-acquired and 624 (68.88%) nosocomial infections were studied an average of 100±25strains by year of study. Overall, the prevalence of MRSA was 13.83% (39 of 282 isolates)for community-acquired strains, and 15.70% (98 of 624) for nosocomial infections (p> 0.05)with a total of 29.53%. Resistance rate to trimethoprim-sulfamethoxazole was significantly higher in nosocomial infection than in community-acquired. No significant difference was observed in other antibiotics. Of the 137 MRSA, except vancomycin, fusidic acid is the antibiotic that worked the most in 114 cases (83.21%) followed by gentamicin in 96 cases (70.07%). Apart from ciprofloxacin and tetracycline that we have noticed an increase in resistance rates in 2012 and 2013, almost all antibiotics tested have a stable rate of resistance.

Conclusion: The antibiotics tested showed extremely high rates of resistance and that the problem of antibiotic resistance in S. aureus is effective in our center.

Keywords: Resistance, antibiotics, S. aureus , HU-JRA ,Antananarivo

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Status of resistance to antimicrobial agents of Staphylococcus aureus strains at the laboratory of microbiology of the HU-JRA Antananarivo

Antimicrobial susceptibility of extended-spectrum beta-lactamase producing Enterobacteriaceae causing urinary tract infections in Ouagadougou, Burkina Faso

D.S. Kpoda, N Guessennd, N.S. Somda, A Ajayi, J.I. Bonkoungou, F Konan, M.B. Ouattara, M Somda, J Simpore, R Ouedraogo, K.M. Drabo, L Sangare, M Dosso, A.S. Traore

 

Abstract

Objective: To determine the frequency of extended-spectrum beta lactamase producing Enterobacteriaceae (ESBL) and other antibioticsresistant bacteria in urinary tract isolates.

Study Design: prospective and experimental study.

Methodology: Place and duration of study :YalgadoOuedraogo University Hospital Center, Charles De Gaulle Pediatric Hospital Center, Saint Camille Hospital and National Public Health Laboratory, Ouagadougou, from November 2014 to October 2015.

AllEnterobacteriaceaestrains isolated from urinary samples of patients were identifiedusing API 20E chemical gallery (BioMerieux, France). All strains were subjected to an array of 14 antibiotics to study their drug susceptibility by using Kirby- Baeurdisk diffusion method. Detection of ESBL was carried out by double disk diffusion technique. Statistical analysis was performed by Microsoft Excel and Anova one-way GrapPad Prism version 5.01. Chi-square (χ2) test was used to determine significance. A p˂ 0.05was considered to be statistically significant.

Results: A total of 324 isolates of Enterobacteriaceae were identified during the study period, including211(65%) E. coli, 75 (23%)Klebsiellaspp., 18 (6%) Enterobacter spp., 11 (3%)Proteus spp., 5 (2%) Citrobacter spp., Serratia spp. 3 (1%).All the clinical isolates were susceptible to imipenem. Resistance to amikacinwas 14% (45/324); gentamicin 54% (175/324); tobramycin 58% (187/324); nalidixic acid 72% (234/324),ciprofloxacin 63% (204/324) and to cotrimoxazole 83% (269/324).The overall rate of the EBSL producing strains was 35% (114/324). Their susceptibility to antibiotics was (imipenem,amikacin, cefoxitin and fosfomycin) 100% (114/114), 93% (106/114), 74% (84/114) and 84% (96/114) respectively. ESBL positivity within individual organism group was highest inEscherichia coli 64% (73/324) followed byKlebsiellaspp. 28% (32/324), Enterobacterspp. 3% (4/324), Proteus spp. and Citrobacterspp. 2% (2/324).

Conclusion: The results showeda high frequency of ESBL producing Enterobacteriaceae, especially Escherichia coli and Klebsiellaspp. The data points to theneed of routine detection and surveillance of ESBL producing bacteria in Burkina Faso.

Keywords: Antimicrobial susceptibility, Enterobacteriaceae, Urine, Burkina Faso

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Antimicrobial susceptibility of extended-spectrum beta-lactamase producing Enterobacteriaceae causing urinary tract infections in Ouagadougou, Burkina Faso

Incidence microbiological profile and drug resistance pattern of uropathogens causing asymptomatic bacteriuria among below poverty line diabetic male patients

S Balamuruganvelu, B Geethavani, S.V. Reddy, R Srikumar, V.K.G. Sundaram

 

Abstract

Introduction: With the prevalence of DM increasing among rural population in developing countries, factors associated with diabetes and its complications also becomes more important. More than half of diabetic patients with ASB have upper urinary tract involvement and the frequency of symptomatic UTI had been significantly higher. Symptomatic UTIs tends to be more common in diabetic subjects with ASB than in those without ASB. Although ASB is of major concern in diabetic population, the long-term consequences of ASB in patients with DM are poorly documented, Almost all studies were performed among elderly women with type 2 diabetes and there is very little information on the occurrence of ASB among BPL diabetic males in our local setting. Hence in the present study the incidence and etiology of ASB among BPL diabetic male patients was monitored along with the resistance pattern of bacterial isolates to antimicrobial agents.

Materials and methods: Clean catch voided midstream urine samples were collected from 1131 BPL Diabetic male patients enrolled for the study. Wet film of centrifuged urine was performed to detect the presence of pus cells, epithelial cells, erythrocytes, microorganisms, cast. Culture was performed using standard loop method and antimicrobial susceptibility of the isolates was studied using Kirby Bauer disc diffusion method following CLSI guidelines.

Results: Out of 1131 BPL diabetic male patients screened for ASB, 155 (13.7%) were culture positive. Among the uropathogens Gram negative bacilli was the most commonest type (72.7%) and the most prevalent organisms isolated was Klebsiella spp (35.2%), Enterococcus spp (22.4%), followed by E. coli (19.4 %) ,Pseudomonas aeruginosa ( 7.3%), etc.,. 87.5% of E.coli isolated were ESBL, followed by 77.6 % of Klebsilla spp and 11.1 % Enteroabacter spp. Pseudomonas aeruginosa reported in this study were 100% ESBL and 16.6% Metallo β lactamase (MBL) producers.8.1 % of Vancomycin resistant Enterococcus (VRE) was also found in this study.

Conclusion: This study demonstrated a high occurrence of ASB in BPL diabetic males (13.7%). Klebsiella was the most commonest uropathogen found in our study followed by Enterococcus , E.coli and PseudomonasE.coli and Pseudomonas showed high rates of drug resistance. Nitrofurantoin and Amikacin was the most effective drugs for majority of the isolates. Hence routine monitoring and screening for ASB in this population is essential. Moreover patients in rural parts of developing countries with diabetes has to be sensitized about the complications of ASB and regarding maintenance of their glycemic control which is of major importance in prevention of the condition.

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Incidence microbiological profile and drug resistance pattern of uropathogens causing asymptomatic bacteriuria among below poverty line diabetic male patients