Antimicrobial drug resistance trends of bacteremia isolates in a rural hospital in southern Mozambique.
Antibiotic resistance in Africa is increasing but insufficiently recognized as a public health problem. However, there are scarce data for antimicrobial resistance trends among bloodstream isolates in sub-Saharan Africa. Antimicrobial drug resistance trends among bacteria isolated from blood of children < 15 years of age admitted to the Manhiça District Hospital in Mozambique during May 2001-April 2006 were monitored by disk diffusion. We documented a linear trend of increasing resistance throughout the study period to chloramphenicol among isolates of Non-typhi Salmonella (P < 0.001), Escherichia coli (P = 0.002), Staphylococcus aureus (P < 0.001), and Haemophilus influenzae (P < 0.001). Increasing resistance to ampicillin was also observed for H. influenzae isolates (P < 0.001). We report trends of increasing resistance among the most frequent etiologies of bacteremia to the most commonly used antibiotics for empirical therapy in this community. Quinolones and third-generation cephalosporines may be needed in the short term to manage community-acquired infections.
Mandomando
Inácio
I
Centro de Investigação em Saúde da Manhiça, Vila da Manhiça, Rua 12, PO Box 1929, Maputo, Mozambique. inacio.mandomando@manhica.net
Sigaúque
Betuel
B
Morais
Luis
L
Espasa
Mateu
M
Vallès
Xavier
X
Sacarlal
Jahit
J
Macete
Eusébio
E
Aide
Pedro
P
Quintò
Llorenç
L
Nhampossa
Tacilta
T
Machevo
Sónia
S
Bassat
Quique
Q
Menéndez
Clara
C
Ruiz
Joaquim
J
Roca
Anna
A
Alonso
Pedro L
PL
D000349:Africa; D017954:Africa South of the Sahara; D000667:Ampicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000503:physiopathology*; D002648:Child; D002701:Chloramphenicol / Q000494:pharmacology; D017714:Community-Acquired Infections; D004352:Drug Resistance, Microbial / Q000502:physiology*; D004756:Enterobacteriaceae Infections / Q000503:physiopathology; D004926:Escherichia coli / Q000187:drug effects; D006192:Haemophilus Infections; D006193:Haemophilus influenzae / Q000187:drug effects; D006780:Hospitals, Rural / Q000706:statistics & numerical data; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000639:trends*; D009073:Mozambique; D012485:Salmonella typhi / Q000187:drug effects; D013211:Staphylococcus aureus / Q000187:drug effects
D000900:Anti-Bacterial Agents; D002701:Chloramphenicol; D000667:Ampicillin