Antimicrobial resistance in Madagascar: a review of the current situation and challenges

Rasamiravaka, T.

Laboratory of Biotechnology and Microbiology, Department of Applied and Fundamental Biochemistry, Faculty of Sciences, University of Antananarivo (UA), BP 906, Antananarivo 101, Madagascar
Correspondence to: travaka@yahoo.fr

Abstract:
Antimicrobial resistance (AMR) is a growing public health threat worldwide occurring in a wide range of pathogenic bacteria. It is encouraging that governments of countries around the world are beginning to pay attention to the issue of AMR that serves to undermine the future of modern medicine. However, each country solution approaches to this issue will differ in terms of magnitude and response capacity. Madagascar is a low-income country and one of the poorest countries in the world with poor environmental hygiene practices and easy availability of antimicrobial drugs without medical prescription. These particular contexts certainly influence the spread of multi-drug resistant bacteria. This review presents reported data on AMR from 2001 to 2018 in Madagascar among the World Health Organization (WHO) priority human pathogens, and determined the scope and magnitude of the AMR problems in the particular context of this low-income country, which could help in formulating effective response strategies for control of AMRs in Madagascar.

Key words: Antimicrobials, Madagascar, Multi-drug resistance, Prevalence

Received December 3, 2019; Revised April 10, 2020; Accepted April 11, 2020
Copyright 2020 AJCEM Open Access. This article is licensed and distributed under the terms of the Creative Commons Attrition 4.0 International License <a rel=”license” href=”//creativecommons.org/licenses/by/4.0/”, which permits unrestricted use, distribution and reproduction in any medium, provided credit is given to the original author(s) and the source.

Résistance aux antimicrobiens à Madagascar: bilan de la situation actuelle et des défis

Rasamiravaka, T.

Laboratoire de biotechnologie et de microbiologie, Département de biochimie appliquée et fondamentale, Faculté des sciences, Université d’Antananarivo (UA), BP 906, Antananarivo 101, Madagascar Continue reading “Antimicrobial resistance in Madagascar: a review of the current situation and challenges”

Prevalence and antibiotic resistance profiles of extended spectrum β-lactamase-producing Escherichia coli among paediatric patients with urinary tract infection in St. Patricks’ Hospital, Mile Four, Abakaliki, Ebonyi State, Nigeria

Iroha, I. R., Onyia, U., *Moses, I. B., Ejikeugwu, C. P., Nwakaeze, A. E., and Ugbo, E. N.
Department of Applied Microbiology, Faculty of Sciences, Ebonyi State University, Abakaliki, Nigeria *Correspondence to: ben_iyke70@yahoo.com

Abstract:
Background: The extended spectrum beta-lactamase (ESBL)-producing Escherichia coli strains which have been implicated in septicaemia among hospitalized children is a serious concern due to their high resistance rates to commonly used antimicrobial agents. The objective of this study was to determine the prevalence and antibiotic susceptibility of urinary ESBL-producing E. coli in paediatric patients who had clinical evidence of urinary tract infections (UTI). Methodology: Clean catch specimens of urine collected from 100 eligible paediatric patients with clinical evidence of UTI in St. Patricks’ Hospital, Mile Four, Abakaliki, Ebonyi State, were cultured for isolation of E. coli using standard bacteriological techniques. Isolates were confirmed for ESBL production by double disk synergy test (DDST), and antibiotic susceptibility of the ESBL-producing ones was determined by the modified Kirby Bauer disk diffusion method. Results: Twenty one (21%) E. coli were isolated out of which 11 (52 %) were ESBL producers, all of which were totally resistant (100%) to cefotaxime, ticarcillin and sulfamethoxazole-trimethoprim, 85% to aztreonam and 83% to ceftazidime. The multiple antibiotic resistance index (MARI) values ranged from 0.4 to 0.9, which implies high usage of antimicrobials Conclusion: The high prevalence of multi-drug resistant ESBL-producing E. coli obtained in this study shows that there has been overuse (abuse or misuse) of antibiotics in the study area. There is need for antimicrobial stewardship programme that will ensure prudent use of antimicrobial agents to forestall the emergence and spread of multi-drug resistant bacteria.

Keywords: Paediatrics, Escherichia coli, ESBL, urine, multi-drug resistance

Received February 8, 2019; Revised May 23, 2019; Accepted May 24, 2019
Copyright 2019 AJCEM Open Access. This article is licensed and distributed under the terms of the Creative Commons Attrition 4.0 International License (//creativecommmons.org/licenses/by/4.0), which permits unrestricted use, distribution and reproduction in any medium, provided credit is given to the original author(s) and the source.

Profils de prévalence et de résistance aux antibiotiques d’Escherichia coli produisant des β-lactamases à spectre étendu chez des patients pédiatriques présentant une infection des voies urinaires à l’hôpital St. Patricks, Mile Four, Abakaliki, État d’Ebonyi, Nigéria

Iroha, I. R., Onyia, U. * Moses, I. B., Ejikeugwu, C. P., Nwakaeze, A. E., et Ugbo, E. N.
Département de microbiologie appliquée, Faculté des sciences, Université d’Ebonyi, Abakaliki, Nigéria *Correspondance à: ben_iyke70@yahoo.com

Abstrait:
Contexte: Les souches d’Escherichia coli productrices de bêta-lactamase à spectre étendu (BLSE) qui ont été impliquées dans la septicémie chez les enfants hospitalisés constituent un grave problème en raison de leur taux de résistance élevé aux agents antimicrobiens couramment utilisés. L’objectif de cette étude était de déterminer la prévalence et la sensibilité aux antibiotiques d’E. coli producteurs de BLSE dans l’urine chez les patients pédiatriques présentant des signes cliniques d’infections des voies urinaires (UTI). Méthodologie: Des échantillons d’urine prélevés chez 100 patients pédiatriques éligibles présentant des signes cliniques d’UTI à l’hôpital St. Patricks, à Mile Four, à Abakaliki, dans l’État d’Ebonyi, ont été cultivés pour l’isolement de E. coli à l’aide de techniques bactériologiques classiques. Les isolats ont été confirmés pour la production de BLSE par un test de synergie à double disque (DDST) et la sensibilité aux antibiotiques des producteurs de BLSE a été déterminée par la méthode de diffusion sur disque de Kirby Bauer modifiée. Résultats: Vingt et un (21%) E. coli ont été isolés, dont 11 (52%) étaient des producteurs de BLSE, qui étaient tous totalement résistants (100%) au céfotaxime, à la ticarcilline et au sulfaméthoxazole-triméthoprime, 85% à l’aztréonam et au 83 % en ceftazidime. Les valeurs de l’indice de résistance multiple aux antibiotiques (MARI) allaient de 0,4 à 0,9, ce qui implique une utilisation élevée d’antimicrobiens Conclusion: La prévalence élevée d’E. coli productrice de BLSE résistante à plusieurs médicaments obtenue dans cette étude montre qu’il y a eu surutilisation (abus ou abus). ) d’antibiotiques dans la zone d’étude. Un programme de gestion des antimicrobiens est nécessaire pour garantir une utilisation prudente des agents antimicrobiens afin de prévenir l’émergence et la propagation de bactéries multirésistantes aux médicaments

Mots-clés: pédiatrie, Escherichia coli, BLSE, urine, multirésistance

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Prevalence and antibiotic resistance profiles of extended spectrum β-lactamase-producing Escherichia coli among paediatric patients with urinary tract infection in St. Patricks’ Hospital, Mile Four, Abakaliki, Ebonyi State, Nigeria