1921
Volume 83, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

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 ( < 0.001), ( = 0.002), ( < 0.001), and ( < 0.001). Increasing resistance to ampicillin was also observed for isolates ( < 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.

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References

  1. Bryce J, Boschi-Pinto C, Shibuya K, Black RE, 2005. WHO estimates of the causes of death in children. Lancet 365: 11471152.[Crossref]
    [Google Scholar]
  2. Berkley JA, Lowe BS, Mwangi I, Williams T, Bauni E, Mwarumba S, Ngetsa C, Slack MP, Njenga S, Hart CA, Maitland K, English M, Marsh K, Scott JA, 2005. Bacteremia among children admitted to a rural hospital in Kenya. N Engl J Med 352: 3947.[Crossref]
    [Google Scholar]
  3. Sigauque B, Roca A, Mandomando I, Morais L, Quinto L, Sacarlal J, Macete E, Nhamposa T, Machevo S, Aide P, Bassat Q, Bardaji A, Nhalungo D, Soriano-Gabarro M, Flannery B, Menendez C, Levine MM, Alonso PL, 2009. Community-acquired bacteremia among children admitted to a rural hospital in Mozambique. Pediatr Infect Dis J 28: 108113.[Crossref]
    [Google Scholar]
  4. Bachou H, Tylleskar T, Kaddu-Mulindwa DH, Tumwine JK, 2006. Bacteraemia among severely malnourished children infected and uninfected with the human immunodeficiency virus-1 in Kampala, Uganda. BMC Infect Dis 6: 160.[Crossref]
    [Google Scholar]
  5. Walsh AL, Phiri AJ, Graham SM, Molyneux EM, Molyneux ME, 2000. Bacteremia in febrile Malawian children: clinical and microbiologic features. Pediatr Infect Dis J 19: 312318.[Crossref]
    [Google Scholar]
  6. Bahwere P, Levy J, Hennart P, Donnen P, Lomoyo W, Dramaix-Wilmet M, Butzler JP, De Mol P, 2001. Community-acquired bacteremia among hospitalized children in rural central Africa. Int J Infect Dis 5: 180188.[Crossref]
    [Google Scholar]
  7. Blomberg B, Manji KP, Urassa WK, Tamim BS, Mwakagile DS, Jureen R, Msangi V, Tellevik MG, Holberg-Petersen M, Harthug S, Maselle SY, Langeland N, 2007. Antimicrobial resistance predicts death in Tanzanian children with bloodstream infections: a prospective cohort study. BMC Infect Dis 7: 43.[Crossref]
    [Google Scholar]
  8. Kariuki S, Revathi G, Kariuki N, Muyodi J, Mwituria J, Munyalo A, Kagendo D, Murungi L, Anthony Hart C, 2005. Increasing prevalence of multidrug-resistant non-typhoidal salmonellae, Kenya, 1994–2003. Int J Antimicrob Agents 25: 3843.[Crossref]
    [Google Scholar]
  9. Bejon P, Mwangi I, Ngetsa C, Mwarumba S, Berkley JA, Lowe BS, Maitland K, Marsh K, English M, Scott JA, 2005. Invasive Gram-negative bacilli are frequently resistant to standard antibiotics for children admitted to hospital in Kilifi, Kenya. J Antimicrob Chemother 56: 232235.[Crossref]
    [Google Scholar]
  10. Gordon MA, Graham SM, Walsh AL, Wilson L, Phiri A, Molyneux E, Zijlstra EE, Heyderman RS, Hart CA, Molyneux ME, 2008. Epidemics of invasive Salmonella enterica serovar Enteritidis and S. enterica Serovar Typhimurium infection associated with multidrug resistance among adults and children in Malawi. Clin Infect Dis 46: 963969.[Crossref]
    [Google Scholar]
  11. Scott JA, Mwarumba S, Ngetsa C, Njenga S, Lowe BS, Slack MP, Berkley JA, Mwangi I, Maitland K, English M, Marsh K, 2005. Progressive increase in antimicrobial resistance among invasive isolates of Haemophilus influenzae obtained from children admitted to a hospital in Kilifi, Kenya, from 1994 to 2002. Antimicrob Agents Chemother 49: 30213024.[Crossref]
    [Google Scholar]
  12. Mandomando I, Jaintilal D, Pons MJ, Valles X, Espasa M, Mensa L, Sigauque B, Sanz S, Sacarlal J, Macete E, Abacassamo F, Alonso PL, Ruiz J, 2009. Antimicrobial susceptibility and mechanisms of resistance in Shigella and Salmonella isolates from children under five years of age with diarrhea in rural Mozambique. Antimicrob Agents Chemother 53: 24502454.[Crossref]
    [Google Scholar]
  13. Ruiz J, Herrera-Leon S, Mandomando I, Macete E, Puyol L, Echeita A, Alonso, 2008. Detection of Salmonella enterica serotype Typhimurium DT104 in Mozambique. Am J Trop Med Hyg 79: 918920.
    [Google Scholar]
  14. Planta MB, 2007. The role of poverty in antimicrobial resistance. J Am Board Fam Med 20: 533539.[Crossref]
    [Google Scholar]
  15. Hart CA, Kariuki S, 1998. Antimicrobial resistance in developing countries. BMJ 317: 647650.[Crossref]
    [Google Scholar]
  16. Valles X, Flannery B, Roca A, Mandomando I, Sigauque B, Sanz S, Schuchat A, Levine M, Soriano-Gabarro M, Alonso P, 2006. Serotype distribution and antibiotic susceptibility of invasive and nasopharyngeal isolates of Streptococcus pneumoniae among children in rural Mozambique. Trop Med Int Health 11: 358366.[Crossref]
    [Google Scholar]
  17. Sigauque B, Roca A, Sanz S, Oliveiras I, Martinez M, Mandomando I, Valles X, Espasa M, Abacassamo F, Sacarlal J, Macete E, Nhacolo A, Aponte J, Levine MM, Alonso PL, 2008. Acute bacterial meningitis among children, in Manhica, a rural area in Southern Mozambique. Acta Trop 105: 2127.[Crossref]
    [Google Scholar]
  18. Ceccarelli D, Mondlane J, Sale M, Salvia AM, Folgosa E, Cappuccinelli P, Colombo MM, 2005. Sporadic methicillin resistance in community acquired Staphylococcus aureus in Mozambique. New Microbiol 28: 327336.
    [Google Scholar]
  19. Roca A, Quinto L, Abacassamo F, Morais L, Valles X, Espasa M, Sigauque B, Sacarlal J, Macete E, Nhacolo A, Mandomando I, Levine MM, Alonso PL, 2008. Invasive Haemophilus influenzae disease in children less than 5 years of age in Manhica, a rural area of southern Mozambique. Trop Med Int Health 13: 818826.[Crossref]
    [Google Scholar]
  20. Alonso PL, Saute F, Aponte JJ, Gómez-Olivé FX, Nhacolo A, Thompson R, Macete E, Abacassamo F, Ventura PJ, Bosch X, Menédez C, Dgedge M, 2002. Manhiça DSS, Mozambique. Population and Health in Developing Countries. Volume 1. Ottawa, Ontario, Canada: INDEPTH, 189195.
    [Google Scholar]
  21. Clinical and Laboratory Standard Institute (CLSI), 2006. Performance Standards for Antimicrobial Disk Susceptibility Tests. Ninth Edition; M2-A9. Wayne, PA: CLSI.
    [Google Scholar]
  22. Ruiz J, 2003. Mechanisms of resistance to quinolones: target alterations, decreased accumulation and DNA gyrase protection. J Antimicrob Chemother 51: 11091117.[Crossref]
    [Google Scholar]
  23. Ruiz J, Gomez J, Navia MM, Ribera A, Sierra JM, Marco F, Mensa J, Vila J, 2002. High prevalence of nalidixic acid resistant, ciprofloxacin susceptible phenotype among clinical isolates of Escherichia coli and other Enterobacteriaceae. Diagn Microbiol Infect Dis 42: 257261.[Crossref]
    [Google Scholar]
  24. Pieroni P, Goodfellow J, Reesor L, Louie M, Simor AE, 1997. Antimicrobial susceptibilities of blood culture isolates obtained before and after the introduction of ciprofloxacin. J Antimicrob Chemother 39: 419422.[Crossref]
    [Google Scholar]
  25. Murray TS, Baltimore R, 2007. Pediatric uses of fluoroquinolone antibiotics. Pediatr Ann 36: 336343.[Crossref]
    [Google Scholar]
  26. Graham SM, English M, 2009. Non-typhoidal salmonellae: a management challenge for children with community-acquired invasive disease in tropical African countries. Lancet 373: 267269.[Crossref]
    [Google Scholar]
  27. Nhacolo A, Nhalungo D, Sacoor CN, Aponte JJ, Thompson R, Alonso PL, 2006. Levels and trends of demographic indices in southern rural Mozambique: evidence from demographic surveillance in Manhiça district. BMC Public Health 6: 291.[Crossref]
    [Google Scholar]
  28. Cotton MF, Wasserman E, Smit J, Whitelaw A, Zar HJ, 2008. High incidence of antimicrobial resistant organisms including extended spectrum beta-lactamase producing Enterobacteriaceae and methicillin-resistant Staphylococcus aureus in nasopharyngeal and blood isolates of HIV-infected children from Cape Town, South Africa. BMC Infect Dis 8: 40.[Crossref]
    [Google Scholar]
  29. Shitu AO, Lin J, 2006. Antimicrobial susceptibility patterns and characterization of clinical isolates of Staphylococcus aureus in KwaZulu Natal Province, South Africa. BMC Infect Dis 6: 125.[Crossref]
    [Google Scholar]
  30. Brink A, Moolman J, da Silva MC, Botha M, the National Antibiotic Surveillance Forum, 2007. Antimicrobial susceptibility profile of selected bacteraemic pathogens from private institutions in South Africa. S Afr Med J 97: 273279.
    [Google Scholar]
  31. Mulla S, Patel M, Shah L, Vaghela G 2007. Study of antibiotic sensitivity pattern of methicillin-resistant Staphylococcus aureus . Indian J Crit Care Med 11: 99101.[Crossref]
    [Google Scholar]
  32. Dalsgaard A, Forslund A, Sandvang D, Arntzen L, Keddy K, 2001. Vibrio cholerae O1 outbreak isolates in Mozambique and South Africa in 1998 are multiple-drug resistant, contain the SXT element and the aadA2 gene located on class 1 integrons. J Antimicrob Chemother 48: 827838.[Crossref]
    [Google Scholar]
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  • Received : 24 Sep 2009
  • Accepted : 23 Feb 2010
  • Published online : 06 Jul 2010
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