Antimicrobial resistance of bacteria isolated from patients with bloodstream infections at a tertiary care hospital in the Democratic Republic of the Congo

Irenge, Léonid M.; Kabego, Landry; Kinunu, Faustin B; Itongwa, Moise; Mitangala, Prudence; Gala, Jean‐Luc; Chirimwami, Raphael B

doi:10.7196/samjnew.7937

Cited by 17 publications

(18 citation statements)

References 29 publications

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“…ESBL‐producing Salmonella have been increasingly reported ; however, ESBLs are less common in nontyphoidal Salmonella than other Gram‐negative bacteria . This is in agreement with our present study in which only 2.4% of the Salmonella isolates were ESBL producers; there was a similarly low prevalence in E. coli isolates in our previous study .…”

Section: Discussionsupporting

confidence: 93%

Prevalence and antimicrobial resistance in Salmonella enterica isolated from broiler chickens, pigs and meat products in Thailand–Cambodia border provinces

Trongjit

Angkititrakul

Tuttle

et al. 2017

Microbiology and Immunology

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This study aimed to examine the prevalence and antimicrobial resistance (AMR) of Salmonella isolates from broiler chickens, pigs and their associated meat products in the Thailand-Cambodia border provinces. A total of 941 samples were collected from pigs and broiler chickens at slaughter houses and from carcasses at local fresh markets in Sa Kaeo, Thailand (n = 554) and Banteay Meanchey, Cambodia (n = 387) in 2014 and 2015. From these samples, 345 Salmonella isolates were collected from Sa Keao (n = 145; 23%) and Banteay Meanchey (n = 200; 47%) and assayed for antimicrobial susceptibility, class 1 integrons and extended-spectrum β-lactamase (ESBL) genes. Serovars Typhimurium (29%) and Rissen (29%) were the most common serotypes found in Thai and Cambodian isolates, respectively. Multidrug resistance was detected in 34% and 52% of isolates from Sa Keao and Banteay Meanchey, respectively. The majority of the Thai isolates were resistant to ampicillin (72.4%), whereas most Cambodian isolates were resistant to sulfamethoxazole (71%). Eleven isolates from Sa Keao and 44 from Banteay Meanchey carried class 1 integrons comprising resistance gene cassettes. The most common gene cassette array was dfrA12-aadA2 (61.1%). Six isolates were ESBL producers. The β-lactamase genes found included bla , bla and bla . Some of these class 1 integrons and ESBL genes were located on conjugative plasmid. In conclusion, multidrug-resistant Salmonella are common in pigs, chickens and their products in the Thailand-Cambodia border provinces. Our findings indicate that class 1 integrons play a role in spread of AMR in the strains in this study.

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Section: Discussionsupporting

confidence: 93%

Prevalence and antimicrobial resistance in Salmonella enterica isolated from broiler chickens, pigs and meat products in Thailand–Cambodia border provinces

Trongjit

Angkititrakul

Tuttle

et al. 2017

Microbiology and Immunology

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“…Current WGS-based genotyping results corroborate our previous observations with ESBL-producing Enterobacteriaceae in urinary and bloodstream isolates in the South Kivu province [19, 20]. Extended set of virulence and AMR genes is expected to provide ESBL-producing E. coli strains capacity for surviving and thriving in their host and surrounding environment in presence of several antimicrobial agents [42].…”

Section: Discussionsupporting

confidence: 83%

“…In two recent studies carried out at a tertiary care hospital in the Eastern province of South Kivu (Fig. 1), we observed a high prevalence of ESBL-producing Enterobacteriaceae in urinary tract and bloodstream infections among which a majority of ESBL-producing E coli in collected isolates [19, 20]. In the current study, a set of 21 ESBL-producing E. coli isolates were analyzed by whole-genome sequencing (WGS).…”

Section: Introductionmentioning

confidence: 95%

Whole-genome sequences of multidrug-resistant Escherichia coli in South-Kivu Province, Democratic Republic of Congo: characterization of phylogenomic changes, virulence and resistance genes

et al. 2019

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BackgroundExtended-spectrum beta-lactamase (ESBL)-producing Escherichia coli are responsible for severe infections worldwide. Whereas their genotypic and pathogenic characteristics are not documented in Democratic Republic of Congo (DRC), recent studies conducted at the Bukavu General Hospital in the South Kivu province highlighted their high prevalence in extra-intestinal infections. Here we provide data on molecular characterization of ESBL producing-Escherichia coli isolates from patients with extra-intestinal infections at this provincial hospital.MethodsWhole-genome sequencing was carried out on 21 of these ESBL-producing Extra-intestinal Pathogenic Escherichia coli (ExPEC) for analysis of phylogenomic evolution, virulence factor and antimicrobial resistance (AMR) genes. Data were compared to phylogenetically close genomes using Multi-Locus Sequence Typing and Single Nucleotide Polymorphism-based phylogenetic approaches.ResultsThe distribution of E. coli sequence types (ST) was as follows: ST 131 (n = 7), ST405 (n = 4), ST410 (n = 2), and other STs (ST10, ST58, ST95, ST393, ST443, S617, ST648, and ST2450). All ST131 belonged to the O25b-ST131 pandemic clone. Unexpectedly, they harbored more virulence genes than their GenBank counterparts. IncF plasmid replicons included novel FIB 69, FII 105 and FII 107 alleles. ESBL-genes included the plasmid-mediated CTX-M-15 in all isolates, and the SHV-12 allele. Other AMR genes included blaOXA-1, blaTEM-1, as well as genes encoding resistance against aminoglycosides, quinolones, chloramphenicol, rifampicin, tetracyclines, sulfonamides and trimethoprim.ConclusionCurrent data confirm the clonal spread of ESBL-producing ST131 and ST405 clones in patients from South Kivu, and the acquisition of resistance and virulence genes. A closer survey of AMR and virulence should therefore be prompted in this high-risk area.Electronic supplementary materialThe online version of this article (10.1186/s12879-019-3763-3) contains supplementary material, which is available to authorized users.

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“…In fact, uropathogens such as E. coli, Klebsiella were found resistant to antimicrobial drugs (Ciprofloxacin, third generation cephalosporin) used for urinary tract infections in Bukavu [31]. Furthermore, high rates of resistance to Cotrimoxazole, erythromycin and moderate to high resistance to Ciprofloxacin, Cefuroxime were observed among Gram-negative bacteria isolated from patients with blood stream infections in South-Kivu [32].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Dispensing Practices in Community Pharmacies: A Major Health Concern in the Eastern Democratic Republic of Congo

Ntizala

Mulume

Runyeruka

et al. 2020

JPRI

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Aims: The practice of antibiotic dispensing in community pharmacies may contribute to irrational use of antibiotics. The aim of this study was to evaluate the antibiotic dispensing patterns in community pharmacies of the Eastern DRCongo. Methods: It is a cross-sectional study carried out at Bukavu city. The study included 1504 subjects attending community pharmacies. Thus, a total number of 40 pharmacies were selected. The sociodemographic profiles of patients and dispensers were also recorded. The pharmacological interventions were investigated in terms of antibiotics dispensed according to patient’s complaints, antibiotic dispensing with or without prescription, the substitution of antibiotics in prescriptions. Results: Participants attending pharmacies for antibiotic needs were in the mean age of 29.8±13 years. Most of the pharmacy workers consisted of pharmacy technicians (70%) and no trained dispensers (20%). Pharmacists represented only 10% of all dispensers in community pharmacies. We found that 67.8% of subjects purchased antibiotics without prescription. The antibiotics dispensed without prescription were either on patients’ requests (70.1%) or the suggestion of dispensers (29.9%). Only 18.4% of prescriptions were subject to substitution. The conditions for requiring antibiotic dispensing without prescriptions were respectively gastrointestinal (34%), respiratory (27%), genitourinary (25%), skin (11%) and dental (2%) infections. Conditions that were not well defined represented 1%. In cephalosporins, Cefixime was the most important drug dispensed without prescription (72.5%) whereas in penicillins, this was Amoxicillin (55.5%). Doxycycline was more dispensed in the class of cyclines (69.4%). Erythromycin (53.1%) and Azithromycin (29.4%) were more dispensed in the class of macrolides. Ciprofloxacin was the most dispensed drug in the class of quinolones (74.3%) and Metronidazole (86.8%) in the class of imidazoles. Conclusion: The Antibiotic dispensing practice is very critical in the community pharmacies of Bukavu city due to the lack of qualified dispensers. This may increase the antibiotic self-medication and contribute to antibiotic resistance.

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Antimicrobial resistance of bacteria isolated from patients with bloodstream infections at a tertiary care hospital in the Democratic Republic of the Congo

Cited by 17 publications

References 29 publications

Prevalence and antimicrobial resistance in Salmonella enterica isolated from broiler chickens, pigs and meat products in Thailand–Cambodia border provinces

Prevalence and antimicrobial resistance in Salmonella enterica isolated from broiler chickens, pigs and meat products in Thailand–Cambodia border provinces

Whole-genome sequences of multidrug-resistant Escherichia coli in South-Kivu Province, Democratic Republic of Congo: characterization of phylogenomic changes, virulence and resistance genes

Antibiotic Dispensing Practices in Community Pharmacies: A Major Health Concern in the Eastern Democratic Republic of Congo

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