title: Antimicrobial drug resistance trends of bacteremia isolates in a rural hospital in southern Mozambique.
abstract: 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.
authors.affiliation: Centro de Investigação em Saúde da Manhiça, Vila da Manhiça, Rua 12, PO Box 1929, Maputo, Mozambique. inacio.mandomando@manhica.net
authors.forename: Inácio
authors.initials: I
authors.lastname: Mandomando
authors.forename: Betuel
authors.initials: B
authors.lastname: Sigaúque
authors.forename: Luis
authors.initials: L
authors.lastname: Morais
authors.forename: Mateu
authors.initials: M
authors.lastname: Espasa
authors.forename: Xavier
authors.initials: X
authors.lastname: Vallès
authors.forename: Jahit
authors.initials: J
authors.lastname: Sacarlal
authors.forename: Eusébio
authors.initials: E
authors.lastname: Macete
authors.forename: Pedro
authors.initials: P
authors.lastname: Aide
authors.forename: Llorenç
authors.initials: L
authors.lastname: Quintò
authors.forename: Tacilta
authors.initials: T
authors.lastname: Nhampossa
authors.forename: Sónia
authors.initials: S
authors.lastname: Machevo
authors.forename: Quique
authors.initials: Q
authors.lastname: Bassat
authors.forename: Clara
authors.initials: C
authors.lastname: Menéndez
authors.forename: Joaquim
authors.initials: J
authors.lastname: Ruiz
authors.forename: Anna
authors.initials: A
authors.lastname: Roca
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Alonso
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D002701:Chloramphenicol; D000667:Ampicillin