[Antibiotic susceptibility of Vibrio cholerae 01: evolution after prolonged curative and preventive use during the 2004 cholera epidemics in Douala (Cameroon)].
Antibiotics were extensively used, both for curative as for prophylactic purposes, to prevent an explosive spread of the 2004 cholera epidemic in Douala. It was thus necessary to control the antibiotic susceptibility of Vibrio cholerae.


OBJECTIVE
The authors had for aim to describe the epidemic, the use of antibiotics, and to follow the susceptibility of V. cholerae.


METHODS
The 14 hospitals in the study all used the same diagnostic, treatment, and preventive protocols, as well as in community practice with home visits. All cases were clinically confirmed and reported. Samples were systematically taken at the beginning and at the end of the epidemic, and randomly during the epidemic. Each identified strain was tested by the disk method for antibiotic susceptibility.


RESULTS
Between January and September 2004, 5013 patients and 177,353 people in contact with the patients were given a single dose of doxycycline or amoxicillin for 3 days. Sixty-nine deaths were recorded (lethality 1.37%). One hundred (and) eleven strains of V. cholerae were identified in 187 samples. All of them were resistant to sulfamides and colistin, but susceptible to cyclins, betalactams, and fluoroquinolones, without any modification during the 8 months of follow-up.


CONCLUSIONS
Despite the risk of a massive and prolonged use of antibiotics, strictly prescribed and controlled, no resistance developed in the identified strain. Chemoprophylaxis must follow rigorous protocols and be continuously monitored.
Guévart
E
E
16, rue de Lille, 59100 Roubaix, France. edouard@yahoo.fr
Solle
J
J
Mouangue
A
A
Noeske
J
J
Bita
A
A
Fonkoua
M-C
MC
Ndayo Wouafo
M
M
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002163:Cameroon / Q000453:epidemiology; D002771:Cholera / Q000188:drug therapy / Q000453:epidemiology*; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D015994:Incidence; D008826:Microbial Sensitivity Tests; D014734:Vibrio cholerae / Q000187:drug effects*
D000900:Anti-Bacterial Agents