Toukam M, Lyonga E.E, Assoumou M.C.O, Fokunang C.N, ,Atashili J, Kechia A.F, Gonsu H.K Mesembe M, Eyoh A, Ikomey G, Akongnwi E, Ndumbe P
Quinolones and fluoroquinolones are frequently used for the presumptive treatment of suspected enterobacterial infections in Cameroon and other resource-limited settings. This study aimed at describing patterns of resistance to quinolones and fluoroquinolones (QFR) in Enterobacteriaceae and thus allow for a better management of patients in these settings. During a 10-month period, a total of 300 enterobacterial strains were isolated from 13 different clinical specimens from hospitalized patients (HP) and community patients (CP). Identification was done using the API 20E. The sensitivity to antibiotics was tested using Kirby-Bauer disk diffusion method according to Clinical Lab. Standard Institute criteria. Out of the 300 isolates identified as Enterobacteriaceae, 58% were from HP while 42% were from CP. The prevalence of each genus was: Escherichia 36%, Klebsiella 33%; Enterobacter 8%, Proteus 8% and others 15%. QFR was detected in 25.7% of all isolates, with a significantly higher prevalence in HP (31.8%) compared to CP (17.3%), p-value=0.0069. Genus-specific resistance rates in HP and CP were respectively: Escherichia 33.3% and 16.7%; Klebsiella 39.7% and 16.7%; Enterobacter 25% and 37.5%; Proteus 9% and 7.7%. Resistance to pipemidic acid and ciprofloxacin was present in 38% and 28% of all isolates respectively. Resistance to more than one quinolone/fluoroquinolone was observed in 36.7% of isolates. QFR resistance was high in this population of Enterobacteriaceae isolates from Cameroon. Resistance was highest in hospital patients and in Klebsiella isolates. Guidelines for presumptive treatment should be implemented for this resistance pattern.
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