Profile of multidrug-resistant clinical bacterial isolates at the National Hospital of Zinder (NHZ), Niger Republic in 2021

*1Abdoulaye, O., 1,2Sidi Maman Bacha, B., 1Hama Aghali, N., 3Abdoulaye, I.,

1Abdoulaye, M. B., 4Lo, G., 5Yacouba, A., 6Chaibou, S., 5Alhousseini Maiga, D.,  1Biraima, A., 1Harouna Amadou, M. L., 7Doutchi, M., 1Bako Saley, M. L.,  1Maman Sani Falissou, S., 1Moussa, M., and 5Mamadou, S.

1Faculté des Sciences de la Santé de l’Université Dan Dicko Dankoulodo de Maradi, Niger

2Hôpital National de Zinder, Niger

3Centre de Recherche Médicale et Sanitaire, Niamey, Niger

4Faculté de Médecine, de Pharmacie et d’Odontostomatologie, Université Cheikh Anta Diop de Dakar, Senegal

5Faculté des Sciences de la Santé, Université Abdou Moumouni, Niamey, Niger

6Hôpital Général de Référence de Niamey, Niger

7Faculté des Sciences de la Santé, Université de Zinder, Niger

*Correspondence to: [email protected]; +227 96354580

 

Abstract:

 Background: Today, bacterial resistance is a public health challenge throughout the world, and infections caused by resistant bacteria are associated with increased morbidity, mortality and health care costs. The objective of this descriptive study is to determine the prevalence and distribution of multi-drug resistant (MDR) clinical bacteria isolates at the National Hospital of Zinder, Niger Republic in 2021.

Methodology: We conducted a descriptive cross-sectional study of in- and out-patients from whose clinical samples’ bacteria were isolated at the bacteriology unit of the laboratory. Bacteria were isolated from the clinical samples following standard aerobic cultures and identified using conventional biochemical test schemes. Antibiotic susceptibility testing (AST) was performed by the agar disk diffusion technique, and categorization of the isolates into sensitive, intermediate or resistant was done according to the recommendations of the Antibiogram Committee of the French Society of Microbiology (CA-SFM) 2020 version 1.2. MDR was defined as resistance to at least one antibiotic in three or more categories, while selected MDR bacteria such as ESBL was identified using double disk synergy test, and MRSA by cefoxitin disk diffusion test.

Results: Seventy-seven (6.7%) bacterial species were isolated from 1153 clinical samples processed at the bacteriology unit of the hospital laboratory between June and December 2021, of which 65.0% (50/77) were members of the order Enterobacteriales. Escherichia coli represented 40.3% (40/77) of the isolated bacteria, Staphylococcus aureus 13.0% (10/77) and Pseudomonas aeruginosa 11.7% (9/77). The overall prevalence of MDR was 44.2% (34/77), including 61.8% (21/34) ESBL-producing Enterobacteriales (ESBL-E), 26.5% (9/34) multi-resistant P. aeruginosa and 11.7% (4/34) MRSA, with 67.6% (23/34) of the MDR isolates from outpatients. Resistance rates of the Enterobacteriales to ciprofloxacin, gentamicin, amikacin and imipenem were

62.0%, 52.0%, 38.0% and 8.0% respectively. Resistance rates of P. aeruginosa were 100.0%, 88.9%, 77.8%, 33.3%, 22.2%, and 22.2% respectively to ceftazidime, ticarcillin, imipenem, ciprofloxacin, levofloxacin, and amikacin. Resistance rates of S. aureus were 100.0%, 50.0%, 40.0%, 10.0%, 0% and 0% to penicillin G, erythromycin, cefoxitin, tetracycline, fusidic acid, and chloramphenicol respectively. ESBL-E were 47.6%, 85.7% and 0% resistant to amikacin, ciprofloxacin and imipenem, and MRSA resistance rates were 75.0%, 75.0%, 50.0% and 0% to erythromycin, tetracycline, gentamicin, and chloramphenicol respectively.

Conclusion: This study reports high prevalence of MDR bacteria, mainly ESBL-E, with concerning high resistance to carbapenem. Rational use of antibiotics and implementation of surveillance system for MDR bacteria must be implemented in order to limit the emergence and spread of MDR bacteria in Niger Republic.

Keywords: MDR bacteria,  inpatient,  outpatient, Zinder, Niger Republic

Received May 1, 2022; Revised Jul 8, 2022; Accepted Jul 9, 2022

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Profile of multidrug-resistant clinical bacterial isolates at the National Hospital of Zinder (NHZ), Niger Republic in 2021