1Mbusa Vihembo, G., 1Mbundu Lukukula, C., 1Ngeleka Ngoie J., 2Indeko Lomboto, J., 2Mpoyo Munanga, L., 3Nzingula Phasi, O., 4Bayebila Menanzambi, T., 5Denis, O., 1TakaisiKikuni, N. B., 1Liesse Iyamba, J. M., and *1Mulwahali Wambale, J.
1University Reference Center of Antimicrobial Resistance Surveillance (URC-AMRS), Faculty of Pharmaceutical Sciences, University of Kinshasa, Kinshasa, Democratic Republic of Congo
2BOYAMBI Hospital Centre Laboratory, Barumbu, Kinshasa, Democratic Republic of Congo
3Biochemistry Laboratory, Faculty of Pharmaceutical Sciences, University of Kinshasa, Kinshasa, Democratic Republic of Congo
4Faculty of Pharmaceutical Sciences, University of Kinshasa, Kinshasa, Democratic Republic of Congo
5National Reference Center for Antimicrobial Resistance in Gram-negative bacilli, CHU UCL NAMUR-Yvoir, Belgium
*Correspondence to: jose.mulwahali@unikin.ac.cd
Abstract:
Background: People living with HIV/AIDS (PLWHA) are prone to opportunistic bacterial infections caused by multidrug-resistant organisms. The aim of this study was to determine the susceptibility of Enterobacterales isolated from urine and stool samples of PLWA attending the BOYAMBI Hospital Center, Kinshasa, Democratic Republic of the Congo to commonly used antibiotics and to detect extended-spectrum β-lactamases (ESBLs) producers among the isolates.
Methodology: A total of 163 HIV-infected patients attending the BOYAMBI Hospital, Kinshasa, DRC, were randomly selected for this study. Urine samples were collected from 108 patients, while stool samples were collected from 55 of them. Samples were cultured in MacConkey agar and identified using conventional microbiological methods. Antibiotic susceptibility on each isolate to selected antibiotics was performed by the disc diffusion method. Phenotypic detection of ESBL was done by the double-disc synergy test.
Results: A total of 120 Enterobacterales were isolated from the samples of the 163 HIV-infected patients with 65 of 108 (60.2%) urine and 55 of 55 (100.0%) stool samples. Escherichia coli was the most frequent bacterial species from both urine and stool with 84 (70.0%), followed by Klebsiellaspecieswith23 (19.2%). Other bacterial pathogens were Citrobacter (n=6, 5.0%), Enterobacter (n=4, 3.3%), Proteus (n=2, 1.7%) and Morganella (n=1, 0.8%) species. Escherichia coli isolates were resistant to amoxicillin (90.5%), sulfa- methoxazole-trimethoprim (81.0%), ciprofloxacin (77.4%), ceftriaxone (77.4%), ceftazidime (73.8%), amoxi- cillin–clavulanic acid (61.9%), imipenem (60.7%), and cefotaxime (50.0%). Klebsiella pneumoniae isolates were resistant to ceftazidime (95.7%), ceftriaxone (91.3%), imipenem (91.3%), ciprofloxacin (87%), sulfa- methoxazole-trimethoprim (78.3%), cefotaxime (56.5%), and amoxicillin–clavulanic acid (52.2%). Citro- bacter, Enterobacter, Morganella and Proteus species were resistant to the majority of antibiotics. The rate of ESBL production was 23.0% (28/120) with Citrobacter spp being the most frequent ESBL-producer, followed Klebsiella spp, Enterobacter spp and E. coli.
Conclusion: The results obtained showed a high rate of ESBL-producing Enterobacterales isolates which were multi-drug resistant. Nitrofurantoin, gentamicin, chloramphenicol, cefixime and nalidixic acid were the most active antibiotics against the isolates.
Keywords: Extended-spectrum β-lactamase, Enterobacterales, HIV/AIDS, Democratic Republic of the Congo
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