title: Results from the Survey of Antibiotic Resistance (SOAR) 2011-14 in the Democratic Republic of Congo, Ivory Coast, Republic of Senegal and Kenya.
abstract: OBJECTIVE
  To assess antibiotic susceptibility of community-acquired respiratory tract isolates from Ivory Coast, Kenya, Democratic Republic of Congo (DRC) and Senegal in 2011-14.
  
  
  METHODS
  Bacterial isolates were collected and MICs determined using Etest(®) for all antibiotics except erythromycin, for which testing was by disc diffusion. Susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. For macrolide interpretation, CLSI breakpoints were adjusted for incubation in CO2.
  
  
  RESULTS
  Susceptibility to penicillin (using CLSI oral or EUCAST breakpoints) was low among isolates of Streptococcus pneumoniae from the DRC and Kenya (17.4% and 19%, respectively) but higher among isolates from the Ivory Coast (70%) and Senegal (85.7%). Penicillin susceptibility using CLSI iv breakpoints was higher in all countries, but still only 69.6% in the DRC. Macrolide susceptibility (based on CLSI erythromycin disc diffusion breakpoints) was also low in Kenya (∼65%) but 87%-100% elsewhere. Haemophilus influenzae were only collected in the DRC and Senegal, with β-lactamase prevalence of 39% and 4%, respectively. Furthermore, β-lactamase-negative ampicillin-resistant (BLNAR) isolates were found in DRC (four isolates, 17%), but only two isolates were found in Senegal (by EUCAST definition). Amoxicillin/clavulanic acid in vitro susceptibility was 73.9% in the DRC and 100% in Senegal based on CLSI breakpoints, but this reduced to 65.2% in the DRC when BLNAR rates were considered. Clarithromycin susceptibility was >95% in both countries.
  
  
  CONCLUSIONS
  There was considerable variability in antibiotic susceptibility among the African countries participating in the surveillance programme. Thus, continued surveillance is necessary to track future changes in antibiotic resistance. Use of EUCAST versus CLSI breakpoints showed profound differences for cefaclor and ofloxacin against S. pneumoniae, with EUCAST showing lower susceptibility.
authors.affiliation: Institute Pasteur, 01 BP 490 Abidjan 01, Côte d'Ivoire.
authors.forename: A
authors.initials: A
authors.lastname: Kacou-Ndouba
authors.affiliation: Department of Pathology, Aga Khan University Hospital, Nairobi, Kenya, PO Box 30270, 00100.
authors.forename: G
authors.initials: G
authors.lastname: Revathi
authors.affiliation: Kenyatta National Hospital, Microbiology Department, P.O. Box 20723, Nairobi, Kenya 00200.
authors.forename: P
authors.initials: P
authors.lastname: Mwathi
authors.affiliation: Institute Pasteur Dakar, Dakar Faculty of Medicine, 36 Avenue Pasteur, B.P. 220, Dakar, Senegal.
authors.forename: A
authors.initials: A
authors.lastname: Seck
authors.affiliation: University of Dakar, Faculty of Medicine, BP 45515, Dakar-Fann, Senegal.
authors.forename: A
authors.initials: A
authors.lastname: Diop
authors.affiliation: University of Kinshasa, National Institute Biomedical Research (INRB), Kinshasa, Democratic Republic of Congo.
authors.forename: M J
authors.initials: MJ
authors.lastname: Kabedi-Bajani
authors.affiliation: GlaxoSmithKline Kenya, 23 Likoni Road, P.O. Box 78392, Nairobi, Kenya 00507.
authors.forename: W
authors.initials: W
authors.lastname: Mwiti
authors.affiliation: GlaxoSmithKline West and Central Africa, 7 Rue des Bougainvilliers Cocody, 01 BP 8111 Abidjan 01, Cote d'Ivoire.
authors.forename: M J
authors.initials: MJ
authors.lastname: Anguibi-Pokou
authors.affiliation: IHMA Europe Sàrl, 9A route de la Corniche, Epalinges 1066, Switzerland.
authors.forename: I
authors.initials: I
authors.lastname: Morrissey
authors.affiliation: GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK didem.x.torumkuney@gsk.com.
authors.forename: D
authors.initials: D
authors.lastname: Torumkuney
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D062665:Epidemiological Monitoring; D005260:Female; D006193:Haemophilus influenzae / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000187:drug effects* / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents