Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Background: Neonatal infection constitutes one of Senegal’s most important public health problems, with amortality rate of 41 deaths per 1,000 live births.Methods: Between January 2007 and March 2008, 242 neonates with suspected infection were recruited at threeneonatal intensive care units in three major tertiary care centers in Dakar, the capital of Senegal. Neonatal infections wereconfirmed by positive bacterial blood or cerebrospinal fluid culture. The microbiological pattern of neonatal infectionsand the antibiotic susceptibility of the isolates were characterized. In addition, the genetic basis for antibiotic resistanceand the genetic background of third-generation cephalosporin-resistant (3GC-R) Enterobacteriaceae were studied.Results: A bacteriological infection was confirmed in 36.4 % (88/242) of neonates: 22.7 % (30/132) during the early-onsetand 52.7 % (58/110) during the late-onset periods (p > 0.20). Group B streptococci accounted for 6.8 % of the 88 collectedbacterial isolates, while most of them were Enterobacteriaceae (n = 69, 78.4 %). Of these, 55/69 (79.7 %) were 3GC-R. TheblaCTX-M-15 allele, the blaSHV and the blaTEM were highly prevalent (63.5, 65.4 and 53.8 %, respectively), usually associatedwith qnr genes (65.4 %). Clonally related strains of 3GC-R Klebsiella pneumoniae and 3GC-R Enterobacter cloacae, the twomost commonly recovered 3GC-R Enterobacteriaceae (48/55), were detected at the three hospitals, underlining the roleof cross-transmission in their spread. The overall case fatality rate was 18.6 %.Conclusions:Measures should be taken to prevent nosocomial infections and the selection of resistant bacteria
ISSN: 1471-2334

Droits : http://creativecommons.org/licenses/by/
hal-01473613
https://hal.archives-ouvertes.fr/hal-01473613
https://hal.archives-ouvertes.fr/hal-01473613/document
https://hal.archives-ouvertes.fr/hal-01473613/file/High%20third-generation%20cephalosporin%20resistant%20Enterobacteriaceae%20prevalence%20rate%20among%20neonatal%20infections%20in%20Dakar%2C%20Senegal.pdf
DOI : 10.1186/s12879-016-1935-y

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Urinary tract infections are bacterial infections most commonly encountered in the community. The resistance rate of uropathogens to commonly prescribed antibiotics has increased worldwide but there are no published data concerning the resistance of strains isolated from community-acquired UTI in Guadeloupe. To assess the susceptibility patterns of Enterobacteriaceae strains isolated from outpatients in Guadeloupe we conducted a prospective study from December 2012 to May 2014 among outpatients consulting at private and public laboratories for urine analysis. Risk factors for E. coli resistance to amoxicillin, third-generation cephalosporin, and ciprofloxacin were also determined. To study the trends of E. coli resistance rates over the past 10 years, data on the susceptibility patterns of E. coli from 2003 to 2014 were also collected from three major laboratories for a retrospective study. During the prospective study, we isolated 1293 bacterial strains from the urine of outpatients presenting for urine analysis. The most commonly isolated bacteria were E. coli (57 %) and Klebsiella pneumoniae (15.5 %). Thirty seven per cent of the E. coli strains were resistant to amoxicillin. Resistance rates to third generation cephalosporin were low for E. coli and other Enterobacteriaceae (3.1 and 12.2 % respectively) and mostly due to the presence of an Extended Spectrum Beta-lactamase. Resistance to cotrimoxazole and ciprofloxacin was moderate (17.8 and 15.6 % respectively). However, the resistance rate of E. coli to ciprofloxacin has significantly increased during the last 10 years. Risk factors were consistent with previously reported data, especially for the increasing ciprofloxacin resistance with age. General practitioners in Guadeloupe need to be better informed to favor the prescription of fosfomycin-trometamol to reduce the risk of resistance to fluoroquinolones.
ISSN: 1471-2180

Droits : http://creativecommons.org/licenses/by/
pasteur-01351191
https://hal-riip.archives-ouvertes.fr/pasteur-01351191
https://hal-riip.archives-ouvertes.fr/pasteur-01351191/document
https://hal-riip.archives-ouvertes.fr/pasteur-01351191/file/art%253A10.1186%252Fs12866-016-0749-9.pdf
PUBMED : 27342199

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
Objective: The first aim of this study was to evaluate the antimicrobial resistance of Enterobacteriaceae in different water environments of Guadeloupe and especially those impacted by waste water treatment plants (WWTP) effluents. The second objective was to characterize the genetic basis for antibiotic resistance of extended-spectrum beta-lactamase (ESBL) and AmpC beta-lactamase producing Enterobacteriaceae isolates (ESBLE and AmpCE).Methods: We have collected 70 surface waters (river and sea samples) impacted or not by WWTP and 18 waste waters from 2 WWTPs in 2012 and 2013. We i) determined the total and resistant bacterial counts and ii) tested isolated Enterobacteriaceae for their antimicrobial susceptibility. We also studied the genetic basis for antibiotic resistance of ESBLE and AmpCE, and the genetic background of Escherichia coli.Results: In rivers, contamination with Escherichia coli and antibiotic resistant coliforms (ARC) increased from the source to the mouth. Highest levels of river contamination with E. coli (9.26 x 105 MPN/100mL) and ARC (2.26 x 108 CFU/mL) were observed in surface water sampled near the discharge. A total of 246 Enterobacteriaceae strains resistant to antibiotics were isolated, mostly from waste waters and from river water collected near the discharge. Among these strains, 33 were Extended Spectrum Beta Lactamase (ESBLE) and 8 E. coli were AmpC beta-lactamase producers. All the ESBLE were isolated from waste waters or from river water collected near the discharge. The blaCTX-M gene was present in 29 of the 33 ESBLE strains, with 24 belonging to group 1. Numerous strains (68.7%) showed more than one acquired antibiotic resistance mechanism. E. coli strains belonged to different phylogenetic groups; among the B2 group, most strains belonged to the ST131 clone.Conclusion: Our results demonstrated that many human activities can supply antibiotic-resistant bacteria in surface water. Nevertheless, WWTPs were the most important supplier of ESBLE in water environment of Guadeloupe.
ISSN: 1932-6203

Droits : http://creativecommons.org/licenses/by/
hal-01485327
http://hal.upmc.fr/hal-01485327
http://hal.upmc.fr/hal-01485327/document
http://hal.upmc.fr/hal-01485327/file/journal.pone.0173155.pdf
DOI : 10.1371/journal.pone.0173155.t002