Phenotipic Prevalence of Antibiotic Resistance in Gabon

Background: The increasing phenomenon of bacterial resistance to antibiotics is a real public health problem. The main causes are poor management of hygiene and water quality, but also the use of antibiotics without precaution. The objective of this study was to isolate and determine the antibiotic resistance profile of the different bacteria found in the main hospitals and bacteriology laboratories in Gabon. Methods: 6034 samples were taken from hospitals in seven main cities of Gabon, and analyzed according to the usual techniques. The pathogenic strains were identified by Matrix-Assisted Laser Desorption Ionization-Time Of Flight Mass Spectrometry. Antimicrobial susceptibility testing was performed by the agar disc diffusion method, according to the Antibiogram Committee of the French Society for Microbiology guidelines. Results: 974 pathogenic bacterial strains were found, including 890/974 (91.4%) Gram-negative bacilli. The systematic antimicrobial susceptibility testings identified 160/974 (16.4%) multi-resistant strains. Escherichia coli was the most represented species. 12.5% - 25% of Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, and Citrobacter sedlakii strains were resistant to amoxicillin + clavulanic acid, third and fourth generation cephalosporins. Aminoglycoside resistance rates of 8.5% - 19% were also noted. 4.5% to 25% of the bacteria found were resistant to quinolones and cotrimoxazole. Resistance rates to carbapenems ranged from 1% to 10.5%. 16% of Staphylococcus aureus were methicillin-resistant (MRSA). Rates of extended spectrum beta-lactamase-producing enterobacteriaceae (ESBL-PE) ranged from 2.5% to 25%. Conclusion: This study showed an increasing evolution of bacterial resistance to antibiotics that are spreading throughout Gabon. This constitutes a threat to the health of Gabonese population.

嗜麦芽窄食单胞菌临床感染诱因及耐药分析

目的为了观察嗜麦芽窄食单胞菌对临床抗生素耐药情况及临床感染诱发因素。方法对临床分离出的３５例嗜麦芽窄食单胞菌进行了感染诱因分析，同时采用肉汤稀释法对抗生素耐药性进行了探讨。结果菌株对头孢一代、头孢二代全部耐药，头孢哌酮耐药率５４．３％，头孢他啶为６０．０％，喹诺酮类体外呈现出较好的抗菌效果。培养阳性的患者当中３４．３％患有恶性肿瘤、２０．０％的患者接受过激素治疗、２２．９％接受过气管插管。结论患者患有其它疾病造成免疫功能低下，增加了嗜麦芽窄食单胞菌感染的机会。各种创伤性检查和治疗手段如气管插管等诱发了细菌感染。嗜麦芽窄食单胞菌对多种抗生素耐药，尤其内酰胺酶类。

临床药师参与1例早产儿嗜麦芽窄食单胞菌感染抗菌药物治疗

目的:探讨临床药师参与特殊人群多重耐药菌抗菌药物治疗的意义。方法:针对1例早产儿嗜麦芽窄食单胞菌感染,临床药师运用专业知识参与抗菌药物治疗方案的制定过程。结果:临床药师利用药学专业知识,结合患儿的生理病理情况,在充分循证证据支持和知情告知下,针对嗜麦芽窄食单胞菌感染提出头孢哌酮/舒巴坦联合环丙沙星的抗菌治疗方案,有效控制了患儿的病情。结论:临床药师可成为临床治疗团队中重要的一员,在抗菌治疗方案制定过程中发挥专业作用,解决临床实际问题,为患者提供有效的个体化治疗,提高临床用药的安全性与有效性。