ABSTRACT
From May 2004 to October 2006, a prospective study was carried out in Dakar, Senegal, to update information about the antimicrobial susceptibility of Shigella spp. isolated from stool specimens. Among the 165 non-duplicate strains collected, 81 (49%) were identified as Shigella flexneri, 75 (45%) as Shigella sonnei, 5 (3%) as Shigella boydii, and 4 (2%) as Shigella dysenteriae. Disk diffusion testing revealed that the majority of isolates were resistant to sulphonamides, trimethoprim-sulfamethoxazole, streptomycin, and tetracycline (respective overall resistance rates: 90, 90, 96, and 94%). More than half of the S. flexneri isolates were resistant to amoxicillin, amoxicillin-clavulanic acid, and chloramphenicol (respective resistance rates: 59, 58, and 52%), and almost all of the S. sonnei isolates were susceptible to these antimicrobials (respective resistance rates: 4, 1, and 4%). Only one isolate (belonging to the species S. sonnei) was resistant to nalidixic acid and displayed reduced susceptibility to ciprofloxacin.
Subject(s)
Anti-Bacterial Agents/pharmacology , Drug Resistance, Bacterial , Dysentery, Bacillary , Shigella/classification , Shigella/drug effects , Adolescent , Adult , Aged , Child , Child, Preschool , Disk Diffusion Antimicrobial Tests , Dysentery, Bacillary/epidemiology , Dysentery, Bacillary/microbiology , Feces/microbiology , Humans , Infant , Middle Aged , Senegal/epidemiology , Shigella/isolation & purification , Shigella boydii/drug effects , Shigella boydii/isolation & purification , Shigella dysenteriae/drug effects , Shigella dysenteriae/isolation & purification , Shigella flexneri/drug effects , Shigella flexneri/isolation & purification , Shigella sonnei/drug effects , Shigella sonnei/isolation & purification , Species SpecificityABSTRACT
BACKGROUND: Data regarding the evolution of antimicrobial resistance are needed to suggest appropriate empirical treatment of urinary tract infections (UTI) in developing countries. To assess the antimicrobial susceptibility of Escherichia coli, the predominant pathogen in community-acquired UTI, a prospective multicenter study was carried out in Dakar, Senegal. METHODOLOGY: From February 2004 to October 2006, 1010 non-duplicate E. coli strains were collected from four centres. Antimicrobial susceptibility testing was performed using disk diffusion method according to the recommendations of the CA-SFM (2004). RESULTS: Most of the isolates were resistant to amoxicillin (73.1%), amoxicillin-clavulanic acid (67.5%), cephalothin (55.8%), and trimethoprim/sulfamethoxazole (68.1%). Extended spectrum beta-lactamase was detected in 38 strains. The overall resistance rates to nalidixic acid, norfloxacin and ciprofloxacin were 23.9%, 16.4% and 15.5%, respectively. Most of the strains were susceptible to gentamicin, nitrofurantoin and fosfomycin (respective susceptibility rates, 93.8%, 89.9%, and 99.3%). During this period, a significant decrease in sensitivity was observed for cephalothin, fluoroquinolones and trimethoprim/sulfamethoxazole (p<0.001). CONCLUSIONS: These data suggest that trimethoprim/sulfamethoxazole may no longer be used as empirical treatment for community-acquired UTI in Dakar. In order to preserve the activity of fluoroquinolones for future years, alternatives such as fosfomycin or nitrofurantoin should be considered.
Subject(s)
Drug Resistance, Multiple, Bacterial , Escherichia coli Infections/microbiology , Escherichia coli/drug effects , Urinary Tract Infections/microbiology , Adolescent , Adult , Community-Acquired Infections/drug therapy , Community-Acquired Infections/epidemiology , Community-Acquired Infections/microbiology , Escherichia coli/isolation & purification , Escherichia coli Infections/drug therapy , Escherichia coli Infections/epidemiology , Female , Humans , Incidence , Male , Microbial Sensitivity Tests , Middle Aged , Outpatients , Pregnancy , Prospective Studies , Senegal/epidemiology , Urinary Tract Infections/drug therapy , Urinary Tract Infections/epidemiology , Young AdultSubject(s)
Anti-Bacterial Agents/pharmacology , Dysentery, Bacillary/microbiology , Shigella/drug effects , Bacterial Typing Techniques , Drug Resistance, Bacterial , Dysentery, Bacillary/epidemiology , Feces/microbiology , Humans , Inpatients , Microbial Sensitivity Tests , Outpatients , Senegal , Serotyping , Shigella/classification , Shigella/isolation & purificationABSTRACT
To assess antibiotic susceptibility among Enterobacteriaceae isolated in urine from outpatients in Dakar, Senegal, a prospective multicenter study involving 3 laboratories had been conducted between June and October 2001. During this period, 300 strains were isolated and susceptibility testing was performed against antibiotics commonly used in treatment of community-acquired urinary tract infections (UTI). E. coli and K. pneumoniae represented 89% of isolates. The overall resistance rates of ampicillin, amoxicillin-clavulanic acid, nalidixic acid, fluoroquinolones and cotrimoxazole were respectively 77.3%, 34.7%, 14.7%, 13.3%, and 55%. In the light of these results, a re-evaluation of first line therapies and prudent use of fluoroquinolones is advised. At the same time a continued surveillance of antimicrobial resistance should be developed in Senegal in order to control the emergence of multidrug resistant strains and to establish a national therapeutic guideline for treatment of UTI.
