Antibio-résistance des souches de Salmonella ssp isolées des hémocultures à Bukavu en RD Congo

Introduction: la fièvre typhoïde est un problème majeur de santé publique dans les pays en voie de développement jusqu'à ce jour à cause de la vétusté des infrastructures sanitaires et des circuits de distribution de l'eau presque inexistant. En RDC en général et à Bukavu en particulier, l'hémoculture est inaccessible à la majorité des patients. L'objectif de cette étude était d'évaluer la sensibilité de Salmonella spp aux antibiotiques couramment utilisés dans la prise en charge de la Fièvre Typhoïde à Bukavu.Méthodes: une étude transversale étalée sur 6 mois était organisée. Tout malade suspect de la Fièvre Typhoïde était sélectionné dans l'étude. L'hémoculture était faite systématiquement chez tout malade sélectionné. L'identification de la souche bactérienne et l'antibiogramme étaient réalisés par de méthodes conventionnelles. Les antibiotiques suivants étaient testés: Amikacine, Amoxicilline, Augmentin, Ceftazidime, Ceftriaxone, Cefuroxime, Chloramphénicol, Ciprofloxacine, Cotrimoxazole, Doxycycline, Gentamicine, Négram, Norfloxacine.Résultats: 460 malades ont été sélectionnés dans l'étude. 144 (31,30%) hémocultures positives ont été observées. Salmonella spp était le germe le plus isolé (41,66%). Les souches de Salmonella spp isolées à Bukavu sont sensibles à la ciprofloxacine (91,7%), au ceftazidime (81,7%), ceftriaxone (80%), norfloxacine (80%), amikacine (76,6%) et au cefuroxime (73,3%). Elles restent résistantes aux autres molécules d'antibiotiques. Conclusion: ces résultats montrent une sensibilité diminuée à la plus part d'antibiotique. Un test d'antibiogramme est requis en cas de fièvre typhoïde pour une meilleure prise en charge

Multidrug Resistance of Salmonella Enterica Serovars Typhi and Als in Western Kenya

Background: The threat to human health posed by antibiotic resistance is of growing concern. Many commensals and pathogenic organisms have developed resistance to well established and newer antibiotics. This is a cross-sectional study within two hospital settings to determine in vitro antibiotic susceptibilities of Salmonella species isolated in blood; cerebral spinal fluid; pus and stool collected from in- and out-patients. The inclusion criteria was non restrictive to in- and out-patient but preference to severe diarrhea cases with negligible changes to previous treatment regimen was observed. The study was carried out from February 2004 - June 2005. Fifty-three diarrhea patients within the hospital who were chosen by convenient sampling and consented to participate in the study were considered. Methodology: Either blood or pus was collected using vacutainer tubes and syringe; swabs respectively; and cerebral spinal fluid by lumbar puncture from patients who had fever (temp = 38oC) and diarrhea. Stool samples were also colle cted and all specimens analyzed for the presence of Salmonella by routine microbiological procedures. The isolates were subjected to antibiotic susceptibility testing using disc diffusion technique. Results: In St. Elizabeth Mukumu Mission Hospital; Salmonella enterica serovar Typhi was most common (56.6; n=33); followed by S. typhimurium (34; n=18); while in Maseno Mission Hospital only S. typhimurium was isolated. Whereas S. typhi was more commonly isolated in male adults and female children (P = 0.9); S. typhimurium was more common in female and male children (P=0.1). All the isolates were sensitive to ciprofloxacin. However; S. typhi was resistant to streptomycin; ampicillin; chloramphenical and cotrimoxazole; S. typhimurium to tetracycline; sulfamethoxazole; cotrimoxazole; ampicillin; chloramphenical and streptomycin. Conclusions: S. typhi displayed a high resistance pattern to most antibiotic screened than S. typhimurium

Studies on the genotoxic and mutagenic potentials of mefloquine

PURPOSE: The detection of mefloquine mutagenicity has not been achieved by the use of Salmonella typhimurium his TA1535; TA1537 as tester strains. With the introduction of improved and more sensitive strains; it is of interest to evaluate the current mutagenic and genotoxic status of the drug. This study presents data on the in-vitro mutagenic and genotoxic potentials of mefloquine hydrochloride clinically used as an antimalarial agent. METHOD : The mutagenicity potentials was investigated in the Escherichia coli WP[2] trp and WP[2] uvrA trp tester strains containing the plasmids; pEB017 and pKM101; and the Salmonella typhimurium TA97 containing pKM101. The genotoxicity potential was determined using the microscreen phage-induction assay. RESULTS: The presence of plasmids pEBO17 and pKM101 enhanced the detection of mutagenicity of mefloquine. Microsomal-activated mefloquine unequivocally elicited base-pair substitution mutagenicity. The genotoxicity test indicated that mefloquine was generally not genotoxic but was of the same potential mutagenicity as chloroquine phosphate. CONCLUSION: Melfloquine hydrochloride exhibits base pair substitution mutagenesis; but not potentially genotoxic; even though it showed concentration dependent cytotoxicity. Its use as a last line antimalarial agent should still be encouraged