Antimicrobial Drug Resistance Trends of Bacteremia Isolates in a Rural Hospital in Southern Mozambique

Abstract

Antibiotic resistance in Africa is increasing but insufficiently recognized as a public health problem. However, there are scarce data for antimicrobial resistance trends among bloodstream isolates in sub-Saharan Africa. Antimicrobial drug resistance trends among bacteria isolated from blood of children < 15 years of age admitted to the Manhiça District Hospital in Mozambique during May 2001–April 2006 were monitored by disk diffusion. We documented a linear trend of increasing resistance throughout the study period to chloramphenicol among isolates of Non-typhi Salmonella (P < 0.001), Escherichia coli (P = 0.002), Staphylococcus aureus (P < 0.001), and Haemophilus influenzae (P < 0.001). Increasing resistance to ampicillin was also observed for H. influenzae isolates (P < 0.001). We report trends of increasing resistance among the most frequent etiologies of bacteremia to the most commonly used antibiotics for empirical therapy in this community. Quinolones and third-generation cephalosporines may be needed in the short term to manage community-acquired infections.

Characterisation of extended-spectrum β-lactamases among Klebsiella pneumoniae isolates causing bacteraemia and urinary tract infection in Mozambique

“…The high prevalence of antibiotic resistance is a matter of special concern as antibiotic therapies are often instituted empirically in the country as well as due to the lack of available second-line alternatives [2,23]. The rates of ESBLs and antibiotic resistance observed in this study may be associated with a complex scenario of treatments derived from the high prevalence of infectious diseases [tuberculosis (TB), malaria, human immunodeficiency virus (HIV), etc.]…”

“…In addition, it was the only antibiotic found to be effective in vitro for MDR E. coli strains with reduced susceptibility to fluoroquinolones [2].…”

“…Until recent years, infections caused by these microorganisms have been successfully treated with the available and inexpensive antibiotics present in these countries. However, the emergence and widespread development of multidrug-resistant (MDR) strains to the early effective antibiotics led to the introduction of broadspectrum antibiotics such as fluoroquinolones or third-generation cephalosporins, which are often unaffordable or unavailable in most low-income countries [2]. Unfortunately, during the last three decades, extended-spectrum b-lactamases (ESBLs) produced by enteric pathogens have spread worldwide since their first description in 1983 [3].…”

Extremely high prevalence of multi-resistance among uropathogens from hospitalised children in Beira, Mozambique

“…Increasing resistance to chloramphenicol among blood culture isolates of non-typhi Salmonella species, Escherichia coli, Staphylococcus aureus and Haemophilus influenzae has been reported. [5] Likewise, high resistance to tetracycline was reported among Neisseria gonorrhoeae isolates, while diarrhoeagenic E. coli isolates showed high resistance to trimethoprim-sulphamethoxazole and ampicillin. [6,7] Urinary tract infection (UTI) is one of the most common bacterial infections encountered by clinicians in developing countries and the cause of significant morbidity and mortality.…”

Caracterización clínico y epidemiológica en pacientes con infección por Enterobacteriaceae productoras de B lactamasas de espectro extendido (BLEE), Hospital Escuela Universitario, Tegucigalpa, Honduras, Año 2013

“…(Perez C, 2003) (Alabi AS, 2013) Así observamos en este estudio que el antibiótico más utilizado en el tratamiento de los pacientes estudiados fue ceftriaxona del cual ambas bacterias no tenían ninguna suceptibilidad lo que constituye un aumento en los costos hospitalarios como también se encontró una baja suceptibilidad a fluorquinolonas iguales hallazgos fueron demostrados en un estudio realizado en un hospital rural al sur de Mozambique . (Mandomando I, 2010) Es de hacer notar la relación del aislamiento de Escherichia coli BLEE en urocultivos y en pacientes del género femenino a diferencia de Klebsiella pneumoniae que se aisló en un mayor porcentaje de hemocultivo aunque las diferencias no fueron estadísticamente significativas esto se debe a la asociación de la E. coli con infecciones urinarias y estas son más frecuente en el sexo femenino sin embargo a los 65 años la relación se invierte debido a la retención e incontinencia urinaria por alteraciones en la próstata. (Dielubanza EJ, 2011 ).…”