Enterobacteria in DRC: Antibiotic Resistance Profile

00:00 Good morning, everybody.

00:05 today my topic is, antimicrobial resistance profile in DRC.

00:14 We will study the resistance of enterobacteria, Staphylococcus aureus, Vibrio cholerae, Mycobacteri tuberculosis, and I will finish by a conclusion.

00:34 Enterobacteria. Why it is important to monitor antibiotic resistance in the family of Enterobacteriaceae? Because the bacteria of this family are the germs most frequently encountered in community and hospital pathologists because also they are the most exposed to antibiotics and therefore likely to develop resistance.

01:12 We conducted antibiotic surveillance resistance in some provinces of DRC as you can see on this map.

01:29 We use the BacT/Alert system for the culture for blood culture in patients. So I show you the distribution of salmonella species routinely isolated between 1994 to 1999 in Kinshasa.

02:00 So we isolated some of these bacteria from the stool, blood, CSF and other samples.

02:15 And salmonella typhimuri was the most important enterobacteria isolated at that time, followed by salmonella paratyphi C, salmonella enteritidis, salmonella typhi, and other species.

02:40 The percentage of significant microorganisms isolated in blood between April 2007 and January 2011 in DRC are as follows.

02:59 Salmonella typhi was the first bacteria that caused blood infection, followed by salmonella species Klebsiella, Escherichia coli, and finally by Staphylococcus aureus.

03:21 Okay, so between 1994 and 1999, we tested the antibiotic resistance of 204 strains of salmonella typhimuri.

03:38 So most of them were resistant to ampicillin and 6 1% present multi-drug resistant.

03:48 We tested also Paratyphi C strain 162 and 80% of the strains were Multi-resistant And we tested 89 strains of Salmonella Enteritidis.

04:04 28% were multi-resistant.

04:07 All strains of typhimurium, Paratyphi C and Anti-arthritis were sensitive to nalidixic acid, but doxycycline was not a good antibiotics for these three species of salmonella.

04:31 We study also the resistance profile of 201 salmonella Typhi to antibiotics between 2000 and 7 and January 2011.

04:51 As you can see on this table, 64% of Salmonella Typhi were resistant to ampicillin and 41% to chloramphenicol, and 57% to co-trimoxazole.

05:15 So 30% of Salmonella Typhi strains were multi-resistant, but the cefotaxime antibiotics was still very active, followed by azithromycin and doxycycline.

05:38 And also we study between 2007 and 2011, the antibiotic resistance of non-typhoidal salmonella in DRC. The first thing was salmonella typhimurium.

05:52 We study 184 strains, and 94% were resistant to ampicillin and 90% to co-trimoxazole and 94 to chloramphenicol, and 86% were multi-resistant.

06:09 An extended spectrum beta lactamase represent 1%, and 3% were resistant to azithromycin and 5% to doxycycline, and we study also 42 strains of salmonella enteritidis.

06:32 59% were multi-resistant, and also other salmonella seven strains, 42 of them were multi-resistant and extended-spectrum beta lactamase was relatively high 14% and also the resistance to azithromycin 14 and doxycycline also 14. So in general, in total 81% of the study strains were multi-resistant. So in September 2010 to May 2011, we conducted a study on antibiotic resistance profile of salmonella species, mainly salmonella enteritidis 64 strain, salmonella typhimurium 20 strain, and salmonella typhi 5 strain.

07:30 So this study was conducted in a rural area of Kisantu.

07:35 So, salmonella enteritidis in Kisantu, as you can see, all were resistant or were resistant to ampicillin, co-trimoxazole, chloramphenicol, multi-drug resistance.

07:49 But there were sensitive to cefotaxime.

07:54 And salmonella typhimuri, we have the same spectr of resistance, and salmonella Typhi 100% were resistant to ampicillin, 80% to co-trimoxazole, and these strains were sensitive to cefotaxime.

08:11 So these are strains isolated in a rural area.

08:15 95% were multi-drug resistant.

08:20 And also we conducted antibiotic resistance profile of salmonella in the equatorial region in Bermuda. This is also a rural area.

08:33 So we found that 97% of non-typhoidal salmonella were multi-resistant and 33% of salmonella typhi were resistant and salmonella typhimuri with reduced susceptibility to ciprofloxacin, only 1%.

09:07 We consider all the antibiotics.

09:10 It is a summary of resistant to all antibiotics.

09:15 And finally we have the typhoid fever.

09:22 So this is the epidemiology of typhoid fever.

09:26 The etiology of the typhoid fever is salmonella typhi.

09:31 And the clinical presentation is characterized by fever, headache, diarrhea. And the most important complication is the intestinal perforation.

09:46 Contaminated water and food street are the most risk factor for the transmission of diseases.

09:58 We call that the disease of dirty hands.

10:03 So now we conducted a study on Klebsiella pneoniae to antibiotics and combined ESBLs.

10:16 We studied 91 strains.

10:19 74 were resistant to co-trimoxazole, 72 to gentamicin and 24 to ciprofloxacin. All strains were sensitive to meropenem, and the percentage of multidrug resistance was 23 and ESBL represents 74%.