title: Antimicrobial resistance in invasive non-typhoid Salmonella from the Democratic Republic of the Congo: emergence of decreased fluoroquinolone susceptibility and extended-spectrum beta lactamases.
abstract: BACKGROUND
  Co-resistance against the first-line antibiotics ampicillin, chloramphenicol and trimethoprim/sulphamethoxazole or multidrug resistance (MDR) is common in non typhoid Salmonella (NTS). Use of alternative antibiotics, such as fluoroquinolones or third generation cephalosporins is threatened by increasing resistance, but remains poorly documented in Central-Africa.
  
  
  RESULTS
  As part of a microbiological surveillance study in DR Congo, blood cultures were collected between 2007 and 2011. Isolated NTS were assessed for serotype and antimicrobial resistance including decreased ciprofloxacin susceptibility and extended-spectrum beta-lactamase (ESBL) production. In total, 233 NTS isolates (representing 23.6% of clinically significant organisms) were collected, mainly consisting of Salmonella Typhimurium (79%) and Salmonella Enteritidis (18%). The majority of NTS were isolated in the rainy season, and recovered from children ≤2 years old. MDR, decreased ciprofloxacin susceptibility, azithromycin and cefotaxime resistance were 80.7%, 4.3%, 3.0% and 2.1% respectively. ESBL production was noted in three (1.3%) isolates. Decreased ciprofloxacin susceptibility was associated with mutations in codon 87 of the gyrA gene, while ESBLs all belonged to the SHV-2a type.
  
  
  CONCLUSIONS
  Presence of almost full MDR among NTS isolates from blood cultures in Central Africa was confirmed. Resistance to fluoroquinolones, azithromycin and third generation cephalosporins is still low, but emerging. Increased microbiological surveillance in DR Congo is crucial for adapted antibiotic therapy and the development of treatment guidelines.
authors.affiliation: National Institute for Biomedical Research, Kinshasa, Democratic Republic of the Congo.
authors.forename: Octavie
authors.initials: O
authors.lastname: Lunguya
authors.forename: Veerle
authors.initials: V
authors.lastname: Lejon
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Phoba
authors.forename: Sophie
authors.initials: S
authors.lastname: Bertrand
authors.forename: Raymond
authors.initials: R
authors.lastname: Vanhoof
authors.forename: Youri
authors.initials: Y
authors.lastname: Glupczynski
authors.forename: Jan
authors.initials: J
authors.lastname: Verhaegen
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Muyembe-Tamfum
authors.forename: Jan
authors.initials: J
authors.lastname: Jacobs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D001769:Blood / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D024881:Drug Resistance, Bacterial; D005260:Female; D024841:Fluoroquinolones / Q000494:pharmacology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012475:Salmonella / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D012480:Salmonella Infections / Q000453:epidemiology / Q000382:microbiology*; D012703:Serotyping; D055815:Young Adult; D001618:beta-Lactamases / Q000378:metabolism; D047090:beta-Lactams / Q000494:pharmacology*
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D047090:beta-Lactams; D001618:beta-Lactamases