Antimicrobial susceptibility of bacterial enteric pathogens isolated in humans from 2002 to 2004 in the Province of South-Kivu, Democratic Republic of Congo

Abstract number: 1134_04_109

Zozo N., Vandenberg O., Mitangala P., Donnen P., Wouafo M., Aïdara-Kane A., Butzler J.

Objectives:  

Diarrheal diseases represent a major health problem in Africa where they account for 15% of all deaths in children. However, little data's are available on the antibiotic resistance of bacterial enteric pathogens in African countries. To develop guidelines for the management of gastroenteritis in the province of South-Kivu, Democratic Republic of Congo, a provincial survey was conducted to determine the antimicrobial susceptibility patterns of enteric pathogens isolated between 2002 and 2004.

Methods:  

During the study period, all bacterial enteric pathogens isolated from blood or stool specimens received at the Provincial Public Health Reference laboratory were identified using conventional laboratory methods. Antimicrobial susceptibility tests were performed by disk diffusion method following the recommendations of the NCCLS. The antimicrobial drugs tested were ampicillin (AM), ceftriaxone (CTX), chloramphenicol (CL), ciprofloxacin (CI), co-trimoxazole (SXT), tetracycline (TC), erythromycin (EM) and amikacin (AK).

Results:  

Among the 182 bacterial enteric pathogens studied, Salmonella spp. (53.3%) were the most commonly identified, followed by Vibrio cholerae (20.9% ), Campylobacter spp. (20.3%), and Shigella spp. (5.5%). Eighty-nine per cent of salmonellae isolates were multidrug resistant with the following proportion of resistant strains to: AMP (92.5%), CL (94.0%), SXT (93.8%), and TC (60.0%). Resistance to CI was uncommon in Salmonella spp. (1.2%) but detected in 16.2% of Campylobacter. All Campylobacter strains were susceptible to EM but 21.6% and 5% of them were resistant to AM and TC respectively. Most of Vibrio cholerae isolates were resistant to CL and SXT but sensitive to AM, CI, TC and AK. Resistance to CI, AK and CTX was not detected in Shigella isolates but all of them were resistant to SXT.

Conclusions:  

Due to the high prevalence of multidrug resistance, third generation cephalosporins or fluoroquinolones are now the drug of choice to treat severe Salmonella infection in the province of South-Kivu. Quinolones should be used with caution as empirical therapy for dysentery because of the increasing incidence of ciprofloxacin resistance in Campylobacter. Erythromycin remains the agent of choice for campylobacter infection.