Diversity and antibiotic resistance of uropathogenic bacteria from Abidjan

Abstract

Background: Urinary tract infections (UTI) are one of the major causes of prescribing and antibiotic consumption. In order to use the best antibiotic treatment for their patients, reliable and recent data about epidemiology and antibiotic resistance profile of uropathogenic bacteria must be available for clinicians. Therefore regular monitoring in each country is required.
Objectives: The aims of this study were to investigate the bacterial pathogenic diversity and antimicrobial resistance rates of uropathogenic bacteria at the Treichville Teaching Hospital (Abidjan, Ivory Coast) over a 12-year period (2000–2011) and also to contribute to the monitoring and the geographical adaptation of antibiotic therapy.
Materials and methods: A retrospective analysis of 12,175 urine samples over a 12-year period 2000–2011 at Treichville Teaching Hospital was carried out according to the routine protocol of urinalysis. The results were processed to obtain the profile prevalence of UTI, the rate of bacterial resistance to antibiotics, the trend of their evolution over time and the rate of multidrug resistance.

Results: The presence of bacteria was detected in about 25% of samples in which 3071 bacterial germs belonging to 12 species were identified. Escherichia coli was the dominant species (28.7%) but much lower than observed in European countries (70–80%). Other main detected species were Staphylococcus aureus (17.4%), Klebsiella pneumoniae (14.9%) and Enterobacter aerogenes (10%). These genera were responsible of 71% of the UTI. Resistance tests to antibiotics indicated very high rates of resistance to amoxicillin (78.9%), tetracyclin (76.4%), and trimethoprim/sulfamethoxazole (77.9%). Only a few molecules maintain their effectiveness such as cefotaxime and netilmicin which respectively exhibit 13.9% and 3.1% of bacterial resistance. However bacterial resistance is increasing over a time for all antibiotics except chloramphenicol.
Conclusions: The diversity of uropathogenic bacteria obtained appeared to be a characteristic of sub- Saharan African countries. Their resistances to different antibiotics were following a dramatic trend. Waiting to be confronted with therapeutic dead end with the advent of multi-resistant bacteria, identifying the region-specific causes is crucial to adapt antibiotic therapy.

Keywords: Urinary tract infections; Antibiotic resistance; Bacterial diversity