Research

Antimicrobial resistance of bacteria isolated from patients with bloodstream infections at a tertiary care hospital in the Democratic Republic of the Congo

Leonid M Irenge, Landry Kabego, Faustin B Kinunu, Moise Itongwa, Prudence N Mitangala, Jean-Luc Gala, Raphael B Chirimwami

Abstract


Background. Bloodstream infection (BSI) is a life-threatening condition that requires rapid antimicrobial treatment.

Methods. We determined the prevalence of bacterial isolates associated with BSI at Bukavu General Hospital (BGH), South Kivu Province, Democratic Republic of the Congo, and their patterns of susceptibility to antimicrobial drugs, from February 2013 to January 2014.

Results. We cultured 112 clinically relevant isolates from 320 blood cultures. Of these isolates, 104 (92.9%) were Gram-negative bacteria (GNB), with 103 bacilli (92.0%) and one coccus (0.9%). Among GNB, Escherichia coli (51.9%), Klebsiella spp. (20.2%), Enterobacter spp. (6.7%), Shigella spp. (5.8%) and Salmonella spp. (4.8%) were the most frequent agents causing BSIs. Other GNB isolates included Proteus spp., Citrobacter spp. and Pseudomonas aeruginosa (both 2.9%), and Acinetobacter spp. and Neisseria spp. (both 0.9%). High rates of resistance to co-trimoxazole (100%), erythromycin (100%) and ampicillin (66.7 - 100%) and moderate to high resistance to ciprofloxacin, ceftazidime, ceftriaxone, cefuroxime and cefepime were observed among GNB. Furthermore, there were high rates of multidrug resistance and of extended-spectrum β-lactamase (ESBL) production phenotype among Enterobacteriaceae. Gram-positive bacteria included three Staphylococcus aureus isolates (2.7%), four oxacillin-resistant coagulase-negative staphylococci (CoNS) isolates (3.6%) and one Streptococcus pneumoniae (0.9%). No oxacillin-resistant S. aureus was isolated. Among clinically relevant staphylococci, susceptibility to co-trimoxazole and ampicillin was low (0 - 25%). In addition, 58 contaminant CoNS were isolated from blood cultures, and the calculated ratio of contaminants to pathogens in blood cultures was 1:2.

Conclusions. Multidrug-resistant and ESBL-producing GNB are the leading cause of BSI at BGH 


Authors' affiliations

Leonid M Irenge, Bukavu General Hospital/Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo; Centre for Applied Molecular Technologies, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium; Defence Laboratories Department, Belgian Armed Forces, Peutie, Belgium

Landry Kabego, Bukavu General Hospital/Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo

Faustin B Kinunu, Bukavu General Hospital/Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo

Moise Itongwa, Bukavu General Hospital/Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo

Prudence N Mitangala, Laboratoire Provincial de Santé Publique du Nord Kivu, Goma, Democratic Republic of the Congo

Jean-Luc Gala, Centre for Applied Molecular Technologies, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium; Defence Laboratories Department, Belgian Armed Forces, Peutie, Belgium

Raphael B Chirimwami, Bukavu General Hospital/Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo

Full Text

PDF (96KB)

Keywords

Bloodstream infection; Blood culture; Multidrug resistance; Prevalence; Extended-spectrum beta-lactamases; Antibiotics

Cite this article

South African Medical Journal 2015;105(9):752-755. DOI:10.7196/SAMJnew.7937

Article History

Date submitted: 2015-02-09
Date published: 2015-09-14

Article Views

Abstract views: 1894
Full text views: 733

Comments on this article

*Read our policy for posting comments here