BackgroundUrinary tract infection (UTI) represents one of the most common diseases encountered in community medical practice. In resource poor settings, treatment is usually empiric due to the high cost and long duration required for reporting diagnosis by culture and antibiotic susceptibility testing. With the growing problem of drug resistance knowledge of antibiotic susceptibility pattern is pertinent for successful eradication of invading pathogens. Our study, the first of its kind in Cameroon, analyzed the distribution and antibiotic susceptibility of bacteria causing community-acquired urinary tract infection (CAUTI) in two towns (Bamenda and Buea) with a large number of young and middle aged persons, to provide data that could guide empiric treatment.FindingsWe cultured 235 urine specimens and analyzed the antibiotic susceptibility of isolates by the disc diffusion technique. Uropathogens were recovered from 137 (58.3%), with prevalence rates in Buea and Bamenda being 65.9% and 54% respectively. Predominant pathogens were Escherichia coli (31.4%), Klebsiella oxytoca (25.5%) and Staphylococcus spp (24.1%). Geographic variation in uropathogen distribution and antibiotic susceptibility was observed, and a significant difference in pathogen distribution with respect to gender. The 20–39 years age group had the highest prevalence of infection. All pathogens isolated were detected in this group. Isolates exhibited low susceptibility to antibiotics tested. Bamenda isolates generally exhibited lower susceptibility compared to those from Buea.ConclusionRegional variation in etiology of CAUTI and antibiotic susceptibility observed in our study emphasizes the need to establish local and national antimicrobial resistance monitoring systems in Cameroon to provide information for the development of CAUTI treatment guidelines.
Cholera remains a significant cause of mortality in developing countries. Outbreaks of the disease are associated with poverty, lack of potable water and poor sanitation. The survival and persistence of Vibrio cholerae in water has been shown to depend on physico-chemical factors. We studied water sources in Bepanda, an overcrowded neighbourhood in Douala, Cameroon, with limited access to portable water and very poor sanitary conditions as reservoirs of V. cholerae. We analysed 318 samples from various sources (well, tap, stream) from February to July 2009 using standard microbiological techniques and characterised isolates serologically using the polyvalent O1/O139 antisera. Susceptibility to antibiotics previously used for cholera treatment in Douala was studied using the disk diffusion method. Physico-chemical factors (temperature, pH and salinity) that could maintain the endemicity of the organism were analysed using standard methods. Eighty-seven (27.4%) samples were contaminated, with high isolation rates being obtained from streams (52.4%) and wells (29.8%). The number of isolates was significantly higher (P < 0.05) in the rainy season (35.5%). We detected 23 (24%) O1 serogroup isolates in streams and wells, whilst 64 (66.6%) were non-O1/non-O139. Temperature and salinity correlated positively with the occurrence of the organisms. All isolates were susceptible to fluoroquinolones but high resistance rates to trimethoprim or sulfamethozaxole and tetracycline were observed.Vibrio cholerae is endemic in Bepanda with O1 and non-O1/non-O139 serogroups co-existing in the streams and wells hence the possibility of future outbreaks of cholera if sanitation and drinking water quality are not improved. Temperature and salinity are amongst the factors maintaining the endemicity of the organism.
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