Document Detail


Antimicrobial resistance of Gram-negative bacilli isolates from inpatients and outpatients at Yaounde Central Hospital, Cameroon.
MedLine Citation:
PMID:  15109589     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine and compare antimicrobial susceptibility patterns of pathogenic bacteria from inpatients and outpatients at a university teaching hospital in Yaounde, Cameroon. METHODS: Gram-negative bacilli isolates (n = 522), obtained from a wide range of clinical specimens (urine, pus and blood) from inpatients and outpatients at Yaounde Central Hospital between March 1995 and April 1998, were evaluated for resistance to antibiotics (amoxicillin, amoxicillin/clavulanate, piperacillin, cefazolin, cefoxitin, cefotaxime, ceftazidime, aztreonam, imipenem, gentamicin, tobramicin, ofloxacin and trimethoprim/sulfamethoxazole). RESULTS: Of the 522 isolates recorded, 80.3% were Enterobacteriaceae. A high incidence of resistance to amoxicillin (85%), piperacillin (75%) and trimethoprim/sulfamethoxazole (71%) was observed. The proportion of antimicrobial-resistant isolates from inpatients was significantly higher than that from outpatients (P < 0.05), except for piperacillin, tobramicin and trimethoprim/sulfamethoxazole. The combinations of antimicrobial and organism showed that the percentage of ceftazidime-resistant Pseudomonas aeruginosa and ceftazidime-resistant Enterobacter cloacae were 26.8% and 24% respectively. The rate of antimicrobial resistance in isolates from inpatients was not significantly higher than that in isolates from outpatients for all the antimicrobial/organism combinations, except for ceftazidime-resistant Escherichia coli, which was exclusively found in isolates from inpatients. Among Enterobacteriaceae, high and low level penicillinase (mostly in E. coli (13.6% and 11% respectively) and Klebsiella spp. (9% and 8% respectively) were the most important beta-lactam resistance phenotypes (31.2% and 23.6%, respectively). Wild type (exclusively observed in E. coli, Proteus mirabilis and Salmonella spp.) and low level penicillinase were higher in outpatient than inpatient isolates (wild type--17.9% vs 10.8% and low level penicillinase--29.4% vs 20.5%, respectively; P < 0.05). However, extended spectrum beta-lactamase strains (Klebsiella spp. (3.5%), E. coli (2.6%), Citrobacter spp. (0.7%), Enterobacter spp. (0.4%) and P. mirabilis (0.2%)) were exclusively recovered from inpatients. Penicillinase and high level cephalosporinase resistance phenotypes were frequently observed in non-fermenter Gram-negative bacilli (46.6% and 29.1% respectively). However, there were no significant differences in penicillinase and cephalosporinase resistance between inpatient and outpatient isolates. CONCLUSION: As the incidence of antimicrobial resistance is substantially higher in isolates from inpatient than outpatient pathogens, more resources should be allocated within the hospital to encourage good antibiotic practices and good hospital hygiene.
Authors:
Joseph Gangoué Piéboji; Sinata Koulla-Shiro; Pierre Ngassam; Dieudonné Adiogo; Thomas Njine; Peter Ndumbe
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases     Volume:  8     ISSN:  1201-9712     ISO Abbreviation:  Int. J. Infect. Dis.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-04-27     Completed Date:  2004-08-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9610933     Medline TA:  Int J Infect Dis     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  147-54     Citation Subset:  IM    
Affiliation:
Laboratory of General Biology, Faculty of Science, University of Yaounde I, P.O. Box 812 Yaounde, Cameroon. jgangoue@yahoo.fr
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / pharmacology*
Cameroon
Community-Acquired Infections / microbiology
Cross Infection / microbiology
Drug Resistance, Bacterial*
Enterobacteriaceae / drug effects
Gram-Negative Bacteria / drug effects*,  isolation & purification
Gram-Negative Bacterial Infections / microbiology
Hospitals, University*
Humans
Inpatients*
Microbial Sensitivity Tests
Outpatients*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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