Epidemiology of beta-lactamases in Africa: correlation with resistance to beta-lactam antibiotics.
In 45 centers from eight African countries, 2,888 bacterial isolates were collected from patients with community-acquired infections. Isolated pathogens included Staphylococcus aureus (29%), Escherichia coli (20%), Neisseria gonorrhoeae (6%), Proteus species (6%), Klebsiella species (6%), Klebsiella pneumoniae (4%), and Staphylococcus epidermidis (4%). An overall sensitivity of 16.2% was shown to penicillin G (number of isolates tested = 2,467), 31.8% to ampicillin (2,687), 45% to amoxicillin (1,959), and 84.9% to cefuroxime (2,888). Beta-lactamase presence was measured by a chromogenic method. Beta-lactamase was found in 75% of all pathogens tested, including 69.5% of gram-negative and 83.3% of gram-positive pathogens; 73% of E coli isolates, 76% of N gonorrhoeae, 75% of Klebsiella species, and 84% of S aureus were beta-lactamase positive. Beta-lactamase presence was associated with bacterial resistance for penicillin G, ampicillin, and amoxicillin, but not cefuroxime, whose sensitivity remained high. The higher resistance rates and beta-lactamase prevalence in Africa suggest the need for national antibiotic prescribing policies and surveillance schemes and replacement of relatively ineffective penicillins with newer agents such as cefuroxime.
Dowse
L J
LJ
Medical Department, Glaxomed Ltd., London, England.
Prigent
B M
BM
D000349:Africa / Q000453:epidemiology; D000658:Amoxicillin / Q000494:pharmacology; D000667:Ampicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects / Q000201:enzymology; D001424:Bacterial Infections / Q000188:drug therapy; D002444:Cefuroxime / Q000031:analogs & derivatives / Q000494:pharmacology; D003141:Communicable Diseases / Q000188:drug therapy / Q000453:epidemiology*; D004352:Drug Resistance, Microbial; D006801:Humans; D010400:Penicillin G / Q000494:pharmacology; D010403:Penicillin Resistance; D011355:Prodrugs / Q000494:pharmacology; D001618:beta-Lactamases / Q000378:metabolism*
D000900:Anti-Bacterial Agents; D011355:Prodrugs; D000667:Ampicillin; D000658:Amoxicillin; D001618:beta-Lactamases; D002444:Cefuroxime; D010400:Penicillin G; C040738:cefuroxime axetil