Two-year surveillance of antibiotic resistance in Streptococcus pneumoniae in four African cities.
Worldwide spread of antibiotic resistance in Streptococcus pneumoniae is a major problem. However, data from West and North African countries are scarce. To study the level of resistance and compare the situations in different cities, a prospective study was conducted in Abidjan (Ivory Coast), Casablanca (Morocco), Dakar (Senegal), and Tunis (Tunisia), from 1996 to 1997. The resistances to eight antibiotics of 375 isolates were studied by E test, and the results were interpreted using the breakpoints recommended by the National Committee for Clinical Laboratory Standards. Overall, 30.4% of the isolates were nonsusceptible to penicillin G (25.6% were intermediate and 4.8% were resistant). Amoxicillin (96.3% were susceptible) and parenteral third-generation cephalosporins (92.7%) were highly active. Resistance to chloramphenicol was detected in 8.6% of the isolates. High levels of resistance were noted for erythromycin (28%), tetracycline (38.3%), and cotrimoxazole (36.4%). Resistance to rifampin was rare (2.1%). There were significant differences in resistance rates between individual countries. Multiple resistance was more frequent in penicillin-nonsusceptible isolates than in penicillin-susceptible isolates. Recommendations for treatment could be generated from these results in each participating country.
Benbachir
M
M
University Hospital Ibn Rochd, Casablanca, Morocco. benbachir@casanet.net.ma
Benredjeb
S
S
Boye
C S
CS
Dosso
M
M
Belabbes
H
H
Kamoun
A
A
Kaire
O
O
Elmdaghri
N
N
D000349:Africa / Q000453:epidemiology; D004352:Drug Resistance, Microbial; D006801:Humans; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D011446:Prospective Studies; D013296:Streptococcus pneumoniae / Q000187:drug effects*