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JAC Advance Access published online on November 29, 2006
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkl466
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Received June 23, 2006
Revised October 8, 2006
Accepted October 20, 2006

Brief report

Antimicrobial resistance among uropathogens that cause community-acquired urinary tract infections in Antananarivo, Madagascar

Frédérique Randrianirina 1, Jean-Louis Soares 1, Jean-François Carod 1, Elisoa Ratsima 1, Vincent Thonnier 1, Patrice Combe 1, Pierre Grosjean 1, and Antoine Talarmin 1 *

1 Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar

* To whom correspondence should be addressed.
Antoine Talarmin, E-mail: atalarmin{at}pasteur.mg


  Abstract

Background: Urinary tract pathogens obtained from patients in Madagascar are becoming increasingly resistant to commonly used antibiotics that are readily available at a low price. This poses a real problem for the treatment of community-acquired urinary tract infections (UTIs) in Madagascar.

Objectives: To obtain data on the pathogens responsible for community-acquired UTIs in Antananarivo and on their susceptibility patterns to the antimicrobial agents that are currently used to treat UTIs.

Methods: We conducted a retrospective study on bacteria isolated from the urine of patients at the Institut Pasteur of Madagascar between January 2004 and April 2006.

Results: We isolated 903 pathogens from 673 women and 213 men. The most commonly isolated bacteria were Escherichia coli (607 strains), Klebsiella pneumoniae (87 strains), Staphylococcus aureus (35 strains) and Proteus mirabilis (32 strains). Seventy-seven per cent of Gram-negative bacilli were resistant to amoxicillin, 65.7% were resistant to trimethoprim/sulfamethoxazole and more than 15% were resistant to ciprofloxacin. Strains were rarely resistant to more expensive antibiotics (ceftriaxone 5.9%, fosfomycin 4.6%). Most bacteria showed intermediate susceptibility to nitroxolin. Resistance rates of E. coli to ceftriaxone and gentamicin increased significantly between 2005 and 2006, due to the increase in strains harbouring an extended-spectrum {beta}-lactamase. Gram-positive bacteria, Streptococcaceae and Staphylococcus spp. were rarely resistant, but 9.5% of streptococci were resistant to penicillin A and 8% of staphylococci were resistant to oxacillin.

Conclusions: The rate of amoxicillin- and trimethoprim/sulfamethoxazole-resistant Enterobacteriaceae implies that another antibiotic should be used for empirical treatment and that there is a need for new generic drugs in developing countries, especially in Madagascar.

Keywords: susceptibility testing; out-patients; UTIs.
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Antibiotic Resistance in Urinary Isolates of Escherichia coli from College Women with Urinary Tract Infections
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[Abstract] [Full Text] [PDF]


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