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Dikoumba AC, Onanga R, Mangouka LG, Boundenga L, Ngoungou EB, Godreuil S. Molecular epidemiology of antimicrobial resistance in central africa: A systematic review. Access Microbiol 2023; 5:acmi000556.v5. [PMID: 37691840 PMCID: PMC10484317 DOI: 10.1099/acmi.0.000556.v5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 07/21/2023] [Indexed: 09/12/2023] Open
Abstract
Background In Central Africa, it is difficult to tackle antibiotic resistance, because of a lack of data and information on bacterial resistance, due to the low number of studies carried out in the field. To fill this gap, we carried out a systematic review of the various studies, and devised a molecular epidemiology of antimicrobial resistance from humans, animals and the environmental samples. Method A systematic search of all publications from 2005 to 2020 on bacterial resistance in Central Africa (Gabon, Cameroon, Democratic Republic of Congo, Central African Republic, Chad, Republic of Congo, Equatorial Guinea, São Tomé and Príncipe, Angola) was performed on Pubmed, Google scholar and African Journals Online (AJOL). All circulating resistance genes, prevalence and genetic carriers of these resistances were collected. The study area was limited to the nine countries of Central Africa. Results A total of 517 studies were identified through a literature search, and 60 studies carried out in eight countries were included. Among all articles included, 43 articles were from humans. Our study revealed not only the circulation of beta-lactamase and carbapenemase genes, but also several other types of resistance genes. To finish, we noticed that some studies reported mobile genetic elements such as integrons, transposons, and plasmids. Conclusion The scarcity of data poses difficulties in the implementation of effective strategies against antibiotic resistance, which requires a health policy in a 'One Health' approach.
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Affiliation(s)
- Annicet-Clotaire Dikoumba
- Département de biologie médicale, Hôpital d’Instruction des Armées Omar Bongo Ondimba, B.P 20404 Libreville, Gabon
- Unité de recherche et d’Analyses Médicales (URAM), Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), B.P. 679 Franceville, Gabon
| | - Richard Onanga
- Unité de recherche et d’Analyses Médicales (URAM), Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), B.P. 679 Franceville, Gabon
| | - Laurette G. Mangouka
- Département de Médecine, Hôpital d’Instruction des Armées Omar Bongo Ondimba, B.P 20404 Libreville, Gabon
| | - Larson Boundenga
- Groupe Evolution et Transmission Inter-espèces des Pathogènes, Département de Parasitologie du Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Unité Maladies Émergentes Virales, Département de Virologie du Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | - Edgard-Brice Ngoungou
- Unité de Recherche en Epidémiologie des Maladies Chroniques et Santé Environnement (UREMCSE), Département d’Epidémiologie, Biostatistiques et Informatique Médicale (DEBIM), Faculté de Médecine, Université des Sciences de la Santé, BP 4009 Libreville, Gabon
| | - Sylvain Godreuil
- Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Montpellier, 191 Avenue du Doyen Gaston Giraud, 34 295 Montpellier Cedex 5, France
- MIVEGEC, IRD, CNRS, Université de Montpellier, Montpellier, France
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Kakumba JM, Kindenge JM, Kapepula PM, Iyamba JML, Mashi ML, Mulwahali JW, Kialengila DM. Evaluation of Antibiotic Prescribing Pattern Using WHO Access, Watch and Reserve Classification in Kinshasa, Democratic Republic of Congo. Antibiotics (Basel) 2023; 12:1239. [PMID: 37627659 PMCID: PMC10451486 DOI: 10.3390/antibiotics12081239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The AWaRe tool was set up by the World Health Organization (WHO) to promote the rational use of antimicrobials. Indeed, this tool classifies antibiotics into four groups: access, watch, reserve and not-recommended antibiotics. In The Democratic Republic of Congo, data on antibiotic dispensing (prescribing) by health professionals according to the AWaRe classification are scarce. In this research work, we aimed to explore antibiotic dispensing pattern from health professionals according to the WHO AWaRe classification to strengthen the national antimicrobial resistance plan. METHODS For this purpose, a survey was conducted from July to December 2022 in the district of Tshangu in Kinshasa. From randomly selected drugstores, drug-sellers were interviewed and randomly selected customers attending those drugstores were included in the study for medical prescriptions collection. The prescribed antibiotics were classified into the access, watch, reserve and not-recommended antibiotics group and by antibiotics number by prescription among pharmacies surveyed. RESULTS 400 medical prescriptions were collected from 80 drugstores and among which, 301 (75.25%) contained antibiotics. Out of 301 prescriptions, we noticed 164 (54.5%) containing one antibiotic, 117 (38.9%) containing two antibiotics, 15 (5%) containing three antibiotics and 5 (1.6%) containing four antibiotics. A total of 463 antibiotics were prescribed and distributed as 169 (36.5%) were from the access group, 200 (43.2%) from the watch group and 94 (20.3%) from not-recommended antibiotics group, respectively. This can explain the fact of emerging bacterial strains, as, according to the WHO recommendations, the access group should be prioritized because of its activity against a wide range of commonly encountered pathogens and its showing low resistance susceptibility compared to antibiotics from other groups. Based on the anatomical, therapeutic and chemical (ATC) classifications, we observed that third generation cephalosporins represented 34.33% of the prescribed antibiotics, followed by penicillins (17.17%), macrolides (7.63%), aminoglycosides (7.36%) and Imidazole (7.36%), thus accounting approximately for 74% of the classes of antibiotics prescribed. Additionally, among them, the most frequently prescribed antibiotics were Ceftriaxone (21.38%), Amoxicillin (11.01%), Gentamycin (5.61%), Amoxicillin-clavulanic acid (5.61%), Azithromycin (4.97%) and Metronidazole (4.75%), thus accounting for approximately 54% of all the prescribed antibiotics. CONCLUSION These results highlight the importance of strict implementation of the national plan to combat antimicrobial resistance and the need to train health workers in the correct application of the WHO AWaRe classification.
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Affiliation(s)
- Jocelyn Mankulu Kakumba
- Laboratory of Drug Analysis, Faculty of Pharmaceutical Sciences, University of Kinshasa, Kinshasa XI 212, Democratic Republic of Congo; (J.M.K.); (D.M.K.)
| | - Jérémie Mbinze Kindenge
- Laboratory of Drug Analysis, Faculty of Pharmaceutical Sciences, University of Kinshasa, Kinshasa XI 212, Democratic Republic of Congo; (J.M.K.); (D.M.K.)
| | - Paulin Mutwale Kapepula
- Centre d’Etudes des Substances Naturelles d’Origine Végétale (CESNOV), Faculty of Pharmaceutical Sciences, University of Kinshasa, Kinshasa XI 212, Democratic Republic of Congo;
| | - Jean-Marie Liesse Iyamba
- Laboratory of Experimental and Pharmaceutical Microbiology, University of Kinshasa, Kinshasa XI 212, Democratic Republic of Congo; (J.-M.L.I.); (J.W.M.)
| | - Murielle Longokolo Mashi
- Département de Médecine Interne, Service de Maladies Infectieuses et Tropicales, Kinshasa XI 212, Democratic Republic of Congo;
| | - Jose Wambale Mulwahali
- Laboratory of Experimental and Pharmaceutical Microbiology, University of Kinshasa, Kinshasa XI 212, Democratic Republic of Congo; (J.-M.L.I.); (J.W.M.)
| | - Didi Mana Kialengila
- Laboratory of Drug Analysis, Faculty of Pharmaceutical Sciences, University of Kinshasa, Kinshasa XI 212, Democratic Republic of Congo; (J.M.K.); (D.M.K.)
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Ogunlaja A, Ogunlaja OO, Olukanni OD, Taylor GO, Olorunnisola CG, Dougnon VT, Mousse W, Fatta-Kassinos D, Msagati TAM, Unuabonah EI. Antibiotic resistomes and their chemical residues in aquatic environments in Africa. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 312:119783. [PMID: 35863703 DOI: 10.1016/j.envpol.2022.119783] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
The aquatic environment is a hotspot for the transfer of antibiotic resistance to humans and animals. Several reviews have put together research efforts on the presence and distribution of antibiotic resistant bacteria (ARB), antibiotic resistance genes (ARGs), and antibiotic chemical residue (ACRs) in food, hospital wastewater, and even in other aquatic environments. However, these reports are largely focused on data from developed countries, while data from developing countries and especially those in Africa, are only marginally discussed. This review is the first effort that distills information on the presence and distribution of ARGs and ACRs in the African aquatic environments (2012-2021). This review provides critical information on efforts put into the study of ARB, ARGs, and ACRs in aquatic environments in Africa through the lens of the different sub-regions in the continent. The picture provided is compared with those from some other continents in the world. It turns out that the large economies in Africa (South Africa, Nigeria, Tunisia, Kenya) all have a few reports of ARB and ARGs in their aquatic environment while smaller economies in the continent could barely provide reports of these in their aquatic environment (in most cases no report was found) even though they have some reports on resistomes from clinical studies. Interestingly, the frequency of these reports of ARB and ARGs in aquatic environments in Africa suggests that the continent is ahead of the South American continent but behind Europe and Asia in relation to providing information on these contaminants. Common ARGs found in African aquatic environment encode resistance to sulfonamide, tetracycline, β-lactam, and macrolide classes of antibiotics. The efforts and studies from African scientists in eliminating ARB and ARGs from the aquatic environment in Africa are also highlighted. Overall, this document is a ready source of credible information for scientists, policy makers, governments, and regional bodies on ARB, ARGs, and ACRs in aquatic environments in Africa. Hopefully, the information provided in this review will inspire some necessary responses from all stakeholders in the water quality sector in Africa to put in more effort into providing more scientific evidence of the presence of ARB, ARGs, and ACRs in their aquatic environment and seek more efficient ways to handle them to curtail the spread of antibiotic resistance among the population in the continent. This will in turn, put the continent on the right path to meeting the United Nations Sustainable Development Goals #3 and #6, which at the moment, appears to be largely missed by most countries in the continent.
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Affiliation(s)
- Aemere Ogunlaja
- African Centre of Excellence for Water and Environmental Research (ACEWATER), Redeemer's University, P.M.B 230, Ede, 232101, Osun State, Nigeria; Department of Biological Sciences, Faculty of Natural Sciences, Redeemer's University, P.M.B 230, Ede, Osun State, Nigeria.
| | - Olumuyiwa O Ogunlaja
- African Centre of Excellence for Water and Environmental Research (ACEWATER), Redeemer's University, P.M.B 230, Ede, 232101, Osun State, Nigeria; Department of Chemical Sciences, Faculty of Natural and Applied Sciences, Lead City University, Ibadan, Nigeria
| | - Olumide D Olukanni
- African Centre of Excellence for Water and Environmental Research (ACEWATER), Redeemer's University, P.M.B 230, Ede, 232101, Osun State, Nigeria; Department of Biochemistry, Faculty of Basic Medical Sciences, Redeemer's University, P.M.B. 230, Ede, Nigeria
| | - Gloria O Taylor
- African Centre of Excellence for Water and Environmental Research (ACEWATER), Redeemer's University, P.M.B 230, Ede, 232101, Osun State, Nigeria; Department of Biological Sciences, Faculty of Natural Sciences, Redeemer's University, P.M.B 230, Ede, Osun State, Nigeria
| | - Chidinma G Olorunnisola
- African Centre of Excellence for Water and Environmental Research (ACEWATER), Redeemer's University, P.M.B 230, Ede, 232101, Osun State, Nigeria; Department of Chemical Sciences, Faculty of Natural Sciences, Redeemer's University, P.M.B 230, Ede, Osun State, Nigeria
| | - Victorien T Dougnon
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Benin
| | - Wassiyath Mousse
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Benin
| | - Despo Fatta-Kassinos
- Department of Civil and Environmental Engineering and Nireas-International Water Research Centre, School of Engineering, University of Cyprus, PO Box 20537, 1678 Nicosia, Cyprus
| | - Titus A M Msagati
- Institute for Nanotechnology and Water Sustainability (iNanoWS), College of Science Engineering and Technology, University of South Africa, South Africa
| | - Emmanuel I Unuabonah
- African Centre of Excellence for Water and Environmental Research (ACEWATER), Redeemer's University, P.M.B 230, Ede, 232101, Osun State, Nigeria; Department of Chemical Sciences, Faculty of Natural Sciences, Redeemer's University, P.M.B 230, Ede, Osun State, Nigeria
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Jesumirhewe C, Springer B, Allerberger F, Ruppitsch W. Genetic Characterization of Antibiotic Resistant Enterobacteriaceae Isolates From Bovine Animals and the Environment in Nigeria. Front Microbiol 2022; 13:793541. [PMID: 35283848 PMCID: PMC8916115 DOI: 10.3389/fmicb.2022.793541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/10/2022] [Indexed: 11/30/2022] Open
Abstract
There is a link between antibiotic resistance in humans, livestock and the environment. This study was carried out to characterize antibiotic resistant bovine and environmental Enterobacteriaceae isolates from Edo state, Nigeria. A total of 109 consecutive isolates of Enterobacteriaceae were isolated from March–May 2015 from 150 fecal samples of healthy bovine animals from three farms at slaughter in Edo state Nigeria. Similarly, 43 Enterobacteriaceae isolates were also obtained from a total of 100 environmental samples from different sources. Isolates were recovered and identified from samples using standard microbiological techniques. Recovered isolates were pre-identified by the Microbact Gram-Negative identification system and confirmed with Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry and ribosomal multilocus sequence typing (rMLST). Antibiotic susceptibility testing was carried out by Kirby-Bauer method for 14 antibiotics. Whole genome sequencing (WGS) was carried out for isolate characterization and identification of resistance determinants. Out of 109 animal and 43 environmental Enterobacteriaceae isolates, 18 (17%) and 8 (19%) isolates based on selection criteria showed antibiotic resistance and were further investigated by whole genome sequencing (WGS). Resistance genes were detected in all (100%) of the resistant bovine and environmental Enterobacteriaceae isolates. The resistance determinants included β-lactamase genes, aminoglycoside modifying enzymes, qnr genes, sulfonamide, tetracycline and trimethoprim resistance genes, respectively. Out of the 18 and 8 resistant animal and environmental isolates 3 (17%) and 2 (25%) were multidrug resistant (MDR) and had resistance determinants which included efflux genes, regulatory systems modulating antibiotic efflux and antibiotic target alteration genes. Our study shows the dissemination of antibiotic resistance especially MDR strains among Nigerian bovine and environmental Enterobacteriaceae isolates. The presence of these resistant strains in animals and the environment constitute a serious health concern indicated by the difficult treatment options of the infections caused by these organisms. To the best of our knowledge we report the first detailed genomic characterization of antibiotic resistance in bovine and environmental Enterobacteriaceae isolates for Nigeria.
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Affiliation(s)
- Christiana Jesumirhewe
- Department of Pharmaceutical Microbiology, Prof Dora Akunyili College of Pharmacy, Igbinedion University, Okada, Nigeria
- *Correspondence: Christiana Jesumirhewe,
| | - Burkhard Springer
- Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Franz Allerberger
- Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Werner Ruppitsch
- Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
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Kimera ZI, Mgaya FX, Mshana SE, Karimuribo ED, Matee MIN. Occurrence of Extended Spectrum Beta Lactamase (ESBL) Producers, Quinolone and Carbapenem Resistant Enterobacteriaceae Isolated from Environmental Samples along Msimbazi River Basin Ecosystem in Tanzania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168264. [PMID: 34444027 PMCID: PMC8394723 DOI: 10.3390/ijerph18168264] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/24/2021] [Accepted: 07/28/2021] [Indexed: 12/18/2022]
Abstract
We conducted environmental surveillance of antimicrobial resistance (AMR) bacteria in the Msimbazi river basin in Tanzania to determine the occurrence of extended-spectrum β-lactamase (ESBL)-producing, carbapenem resistant Enterobacteriaceae (CRE) and quinolone resistant Escherichia coli and Klebsiella spp. A total of 213 Enterobacteriaceae isolates were recovered from 219 samples. Out of the recovered isolates, 45.5% (n = 97) were Klebsiella pneumoniae and 29.6% (n = 63) were Escherichia coli. K. pneumoniae isolates were more resistant in effluent (27.9%) compared to the E. coli (26.6%). The E. coli had a higher resistance in river water, sediment and crop soil than the K. pneumoniae (35 versus 25%), respectively. Higher resistance in K. pneumoniae was found in nalidixic acid (54.6%) and ciprofloxacin (33.3%) while the E. coli isolates were highly resistant to ciprofloxacin (39.7%) and trimethoprim/sulfamethoxazole (38%). Resistance increased from 28.3% in Kisarawe, where the river originates, to 59.9% in Jangwani (the middle section) and 66.7% in Upanga West, where the river enters the Indian Ocean. Out of 160 E. coli and K. pneumoniae isolates, 53.2% (n = 85) were resistant to more than three classes of the antibiotic tested, occurrence being higher among ESBL producers, quinolone resistant and carbapenem resistant strains. There is an urgent need to curb environmental contamination with antimicrobial agents in the Msimbazi Basin.
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Affiliation(s)
- Zuhura I. Kimera
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam 11103, Tanzania; (F.X.M.); (M.I.N.M.)
- Ministry of Livestock and Fisheries, Mtumba Area, P.O. Box 2182, Dodoma 40487, Tanzania
- Correspondence:
| | - Fauster X. Mgaya
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam 11103, Tanzania; (F.X.M.); (M.I.N.M.)
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza 33109, Tanzania;
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297, Morogoro 67125, Tanzania;
| | - Esron D. Karimuribo
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297, Morogoro 67125, Tanzania;
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro 67125, Tanzania
| | - Mecky I. N. Matee
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam 11103, Tanzania; (F.X.M.); (M.I.N.M.)
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297, Morogoro 67125, Tanzania;
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Ouchar Mahamat O, Kempf M, Lounnas M, Tidjani A, Hide M, Benavides JA, Carrière C, Bañuls AL, Jean-Pierre H, Ouedraogo AS, Dumont Y, Godreuil S. Epidemiology and prevalence of extended-spectrum β-lactamase- and carbapenemase-producing Enterobacteriaceae in humans, animals and the environment in West and Central Africa. Int J Antimicrob Agents 2020; 57:106203. [PMID: 33075511 DOI: 10.1016/j.ijantimicag.2020.106203] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/29/2020] [Accepted: 10/11/2020] [Indexed: 12/17/2022]
Abstract
Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) and carbapenemase-producing Enterobacteriaceae (CPE) are widespread. Here we used the 'One Health' approach to determine knowledge gaps on ESBL-E and CPE in West and Central Africa. We searched all articles on ESBL-E and CPE in these African regions published in PubMed, African Journals Online and Google Scholar from 2000 onwards. Among the 1201 articles retrieved, we selected 165 studies (West Africa, 118; Central Africa, 47) with data from 22 of the 26 West and Central Africa countries. Regarding the settings, 136 articles focused only on humans (carriage and/or infection), 6 articles on humans and animals, 13 on animals, 1 on humans and the environment, 8 on the environment and 1 on humans, animals and environments. ESBL-E prevalence ranged from 11-72% in humans and 7-79% in aquatic environments (wastewater). In animals, ESBL-E prevalence hugely varied: 0% in cattle, 11-36% in chickens, 20% in rats, 21-71% in pigs and 32-75% in dogs. The blaCTX-M-15 gene was the predominant ESBL-encoding gene and was associated with plasmids of incompatibility groups F, H, K, Y, N, I1 and R. CPE were studied only in humans. Class B metallo-β-lactamases (NDM) and class D oxacillinases (OXA-48 and OXA-181) were the most common carbapenemases. Our results show major knowledge gaps, particularly on ESBL and CPE in animals and the environment, that might limit antimicrobial resistance management in these regions. The results also emphasise the urgent need to improve active surveillance programmes in each country and to support antimicrobial stewardship.
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Affiliation(s)
- Oumar Ouchar Mahamat
- Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France; MIVEGEC, IRD, CNRS, Université de Montpellier, Montpellier, France; Service de laboratoire, Hôpital de la Mère et de l'Enfant, N'Djaména, Chad.
| | - Marie Kempf
- CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France, and Laboratoire de Bactériologie-Hygiène, Institut de Biologie en Santé - PBH, CHU Angers, Angers, France
| | - Manon Lounnas
- Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France; MIVEGEC, IRD, CNRS, Université de Montpellier, Montpellier, France
| | | | - Mallorie Hide
- MIVEGEC, IRD, CNRS, Université de Montpellier, Montpellier, France
| | - Julio A Benavides
- Departamento de Ecología y Biodiversidad, Facultad de Ciencias de la Vida, Universidad Andrés Bello, Santiago, Chile; Centro de Investigación para la Sustentabilidad, Facultad de Ciencias de la Vida, Universidad Andrés Bello, Santiago, Chile
| | - Christian Carrière
- Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France; MIVEGEC, IRD, CNRS, Université de Montpellier, Montpellier, France
| | - Anne-Laure Bañuls
- Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France; MIVEGEC, IRD, CNRS, Université de Montpellier, Montpellier, France; Laboraoire Mixte International, DRISA, IRD, Montpellier, France
| | - Hélène Jean-Pierre
- Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France; MIVEGEC, IRD, CNRS, Université de Montpellier, Montpellier, France
| | | | - Yann Dumont
- Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France; MIVEGEC, IRD, CNRS, Université de Montpellier, Montpellier, France
| | - Sylvain Godreuil
- Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France; MIVEGEC, IRD, CNRS, Université de Montpellier, Montpellier, France; Laboraoire Mixte International, DRISA, IRD, Montpellier, France
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Lupande-Mwenebitu D, Baron SA, Nabti LZ, Lunguya-Metila O, Lavigne JP, Rolain JM, Diene SM. Current status of resistance to antibiotics in the Democratic Republic of the Congo: A review. J Glob Antimicrob Resist 2020; 22:818-825. [PMID: 32688007 DOI: 10.1016/j.jgar.2020.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/23/2020] [Accepted: 07/04/2020] [Indexed: 11/29/2022] Open
Abstract
A review of literature was conducted to assess the prevalence and mechanisms of antibiotic resistance to date, mainly to β-lactam antibiotics, cephalosporins, carbapenems, colistin, and tigecycline in the Democratic Republic of the Congo (DRC). English and French publications were listed and analysed using PubMed/Medline, Google Scholar, and African Journals database between 1 January 1990 and 31 December 2019. For the 30 published articles found: (1) bacterial resistance to antibiotics concerned both Gram-negative and Gram-positive bacteria; (2) multidrug resistance prevalence was the same in half of Streptococcus pneumoniae isolates; (3) a worrying prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was noted, which is associated with co-resistance to several other antibiotics; and (4) resistance to third-generation cephalosporins was very high in Enterobacteriaceae, mainly because of blaCTX-M-1 group and blaSHV genes. Data on carbapenem and colistin resistance were not available in DRC until recently. Further work is required to set up a surveillance system for antibiotic resistance in DRC.
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Affiliation(s)
- David Lupande-Mwenebitu
- Faculté de Pharmacie, IRD, APHM, MEPHI, Aix Marseille University, 19-21 Boulevard Jean Moulin, 13385 Marseille, France; Université Catholique de Bukavu (UCB), Hôpital Provincial Général de Référence de Bukavu, Bukavu, Congo
| | - Sophie Alexandra Baron
- Faculté de Pharmacie, IRD, APHM, MEPHI, Aix Marseille University, 19-21 Boulevard Jean Moulin, 13385 Marseille, France
| | - Larbi Zakaria Nabti
- Faculté de Pharmacie, IRD, APHM, MEPHI, Aix Marseille University, 19-21 Boulevard Jean Moulin, 13385 Marseille, France
| | | | - Jean-Philippe Lavigne
- Service de Microbiologie et Hygiène hospitalière, VBMI, INSERM U1047, Université de Montpellier, CHU Nîmes, Nîmes, France
| | - Jean-Marc Rolain
- Faculté de Pharmacie, IRD, APHM, MEPHI, Aix Marseille University, 19-21 Boulevard Jean Moulin, 13385 Marseille, France; IHU Méditerranée Infection, 19-21 boulevard Jean Moulin, 13385 Marseille, France.
| | - Seydina Mouhamadou Diene
- Faculté de Pharmacie, IRD, APHM, MEPHI, Aix Marseille University, 19-21 Boulevard Jean Moulin, 13385 Marseille, France; IHU Méditerranée Infection, 19-21 boulevard Jean Moulin, 13385 Marseille, France.
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Kimera ZI, Mshana SE, Rweyemamu MM, Mboera LEG, Matee MIN. Antimicrobial use and resistance in food-producing animals and the environment: an African perspective. Antimicrob Resist Infect Control 2020; 9:37. [PMID: 32122406 PMCID: PMC7053060 DOI: 10.1186/s13756-020-0697-x] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 02/07/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The overuse of antimicrobials in food animals and the subsequent contamination of the environment have been associated with development and spread of antimicrobial resistance. This review presents information on antimicrobial use, resistance and status of surveillance systems in food animals and the environment in Africa. METHODS Information was searched through PubMed, Google Scholar, Web of Science, and African Journal Online databases. Full-length original research and review articles on antimicrobial use, prevalence of AMR from Africa covering a period from 2005 to 2018 were examined. The articles were scrutinized to extract information on the antimicrobial use, resistance and surveillance systems. RESULTS A total of 200 articles were recovered. Of these, 176 studies were included in the review while 24 articles were excluded because they were not relevant to antimicrobial use and/or resistance in food animals and the environment. The percentage of farms using antimicrobials in animal production ranged from 77.6% in Nigeria to 100% in Tanzania, Cameroon, Zambia, Ghana and Egypt. The most antibiotics used were tetracycline, aminoglycoside and penicillin groups. The percentage of multi drug resistant isolates ranged from 20% in Nigeria to 100% in South Africa, Zimbabwe and Tunisia. In the environment, percentage of multi drug resistant isolates ranged from 33.3% in South Africa to 100% in Algeria. None of the countries documented national antimicrobial use and resistance surveillance system in animals. CONCLUSION There is high level of antimicrobial use, especially tetracycline, aminoglycoside and penicillin in animal production systems in Africa. This is likely to escalate the already high prevalence of antimicrobial resistance and multi drug resistance in the continent. This, coupled with weak antimicrobial resistance surveillance systems in the region is a great concern to the animals, environment and humans as well.
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Affiliation(s)
- Zuhura I Kimera
- Department of Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
- Ministry of Livestock and Fisheries, Dodoma, Tanzania.
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Mark M Rweyemamu
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Chuo Kikuu Morogoro, Tanzania
| | - Leonard E G Mboera
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Chuo Kikuu Morogoro, Tanzania
| | - Mecky I N Matee
- Department of Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Chuo Kikuu Morogoro, Tanzania
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Jacobs J, Hardy L, Semret M, Lunguya O, Phe T, Affolabi D, Yansouni C, Vandenberg O. Diagnostic Bacteriology in District Hospitals in Sub-Saharan Africa: At the Forefront of the Containment of Antimicrobial Resistance. Front Med (Lausanne) 2019; 6:205. [PMID: 31608280 PMCID: PMC6771306 DOI: 10.3389/fmed.2019.00205] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 09/03/2019] [Indexed: 12/28/2022] Open
Abstract
This review provides an update on the factors fuelling antimicrobial resistance and shows the impact of these factors in low-resource settings. We detail the challenges and barriers to integrating clinical bacteriology in hospitals in low-resource settings, as well as the opportunities provided by the recent capacity building efforts of national laboratory networks focused on vertical single-disease programmes. The programmes for HIV, tuberculosis and malaria have considerably improved laboratory medicine in Sub-Saharan Africa, paving the way for clinical bacteriology. Furthermore, special attention is paid to topics that are less familiar to the general medical community, such as the crucial role of regulatory frameworks for diagnostics and the educational profile required for a productive laboratory workforce in low-resource settings. Traditionally, clinical bacteriology laboratories have been a part of higher levels of care, and, as a result, they were poorly linked to clinical practices and thus underused. By establishing and consolidating clinical bacteriology laboratories at the hospital referral level in low-resource settings, routine patient care data can be collected for surveillance, antibiotic stewardship and infection prevention and control. Together, these activities form a synergistic tripartite effort at the frontline of the emergence and spread of multi-drug resistant bacteria. If challenges related to staff, funding, scale, and the specific nature of clinical bacteriology are prioritized, a major leap forward in the containment of antimicrobial resistance can be achieved. The mobilization of resources coordinated by national laboratory plans and interventions tailored by a good understanding of the hospital microcosm will be crucial to success, and further contributions will be made by market interventions and business models for diagnostic laboratories. The future clinical bacteriology laboratory in a low-resource setting will not be an "entry-level version" of its counterparts in high-resource settings, but a purpose-built, well-conceived, cost-effective and efficient diagnostic facility at the forefront of antimicrobial resistance containment.
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Affiliation(s)
- Jan Jacobs
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
- Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Liselotte Hardy
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Makeda Semret
- JD MacLean Centre for Tropical Diseases, McGill University, Montreal, QC, Canada
| | - Octavie Lunguya
- Department of Clinical Microbiology, National Institute of Biomedical Research, Kinshasa, Democratic Republic of Congo
- Service of Microbiology, Kinshasa General Hospital, Kinshasa, Democratic Republic of Congo
| | - Thong Phe
- Sihanouk Hospital Center of HOPE, Phnom Penh, Cambodia
| | - Dissou Affolabi
- Clinical Microbiology, Centre National Hospitalier et Universitaire Hubert Koutoukou MAGA, Cotonou, Benin
| | - Cedric Yansouni
- JD MacLean Centre for Tropical Diseases, McGill University, Montreal, QC, Canada
| | - Olivier Vandenberg
- Center for Environmental Health and Occupational Health, School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
- Innovation and Business Development Unit, LHUB - ULB, Pôle Hospitalier Universitaire de Bruxelles (PHUB), Université Libre de Bruxelles (ULB), Brussels, Belgium
- Division of Infection and Immunity, Faculty of Medical Sciences, University College London, London, United Kingdom
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Obasi A, Nwachukwu S, Ugoji E, Kohler C, Göhler A, Balau V, Pfeifer Y, Steinmetz I. Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae from Pharmaceutical Wastewaters in South-Western Nigeria. Microb Drug Resist 2017; 23:1013-1018. [PMID: 28375698 DOI: 10.1089/mdr.2016.0269] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Emergence and spread of Klebsiella pneumoniae isolates producing extended-spectrum β-lactamases (ESBLs) present a major threat to public health. In this study, we characterized β-lactam-resistant K. pneumoniae isolates from six wastewater samples obtained from two pharmaceutical industries located in Lagos and Ogun States, Nigeria. Bacteria were isolated by using MacConkey agar; species identification and antibacterial susceptibility testing were performed by Vitek 2. Etest was used for ESBL phenotype confirmation. The presence of β-lactamase genes was investigated by PCR and sequencing. Bacterial strain typing was done by XbaI-macrorestriction and subsequent pulsed-field gel electrophoresis (PFGE) as well as multilocus sequence typing (MLST). Thirty-five bacterial species were isolated from the six samples; among them, we identified seven K. pneumoniae isolates with resistance to β-lactams and co-resistance to fluoroquinolones, aminoglycosides, and folate pathway inhibitors. The ESBL phenotype was confirmed in six K. pneumoniae isolates that harbored ESBL genes blaCTX-M-15 (n = 5), blaSHV-2 (n = 1), and blaSHV-12 (n = 1). PFGE and MLST analysis revealed five clones belonging to four sequence types (ST11, ST15, ST37, ST101), and clone K. pneumoniae-ST101 was present in the wastewater samples from two different pharmaceutical industries. Additionally performed conjugation assays confirmed the location of β-lactamase genes on conjugative plasmids. This is the first confirmation of K. pneumoniae isolates producing CTX-M-15-ESBL from pharmaceutical wastewaters in Nigeria. The co-resistance observed might be a reflection of the different drugs produced by these industries. Continuous surveillance of the environmental reservoirs of multidrug-resistant bacteria is necessary to prevent their further spread.
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Affiliation(s)
- Avemaria Obasi
- 1 Department of Microbiology, University of Lagos , Lagos, Nigeria
| | | | - Esther Ugoji
- 1 Department of Microbiology, University of Lagos , Lagos, Nigeria
| | - Christian Kohler
- 2 Department of Medical Microbiology, Friedrich Loeffler Institute for Medical Microbiology, University of Greifswald , Greifswald, Germany
| | - André Göhler
- 2 Department of Medical Microbiology, Friedrich Loeffler Institute for Medical Microbiology, University of Greifswald , Greifswald, Germany
| | - Veronica Balau
- 2 Department of Medical Microbiology, Friedrich Loeffler Institute for Medical Microbiology, University of Greifswald , Greifswald, Germany
| | - Yvonne Pfeifer
- 3 FG13 Nosocomial Pathogens and Antibiotic Resistance, Robert Koch Institute , Wernigerode, Germany
| | - Ivo Steinmetz
- 2 Department of Medical Microbiology, Friedrich Loeffler Institute for Medical Microbiology, University of Greifswald , Greifswald, Germany
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Rodríguez-Baño J, Cisneros JM, Cobos-Trigueros N, Fresco G, Navarro-San Francisco C, Gudiol C, Horcajada JP, López-Cerero L, Martínez JA, Molina J, Montero M, Paño-Pardo JR, Pascual A, Peña C, Pintado V, Retamar P, Tomás M, Borges-Sa M, Garnacho-Montero J, Bou G. Diagnosis and antimicrobial treatment of invasive infections due to multidrug-resistant Enterobacteriaceae. Guidelines of the Spanish Society of Infectious Diseases and Clinical Microbiology. Enferm Infecc Microbiol Clin 2015; 33:337.e1-337.e21. [DOI: 10.1016/j.eimc.2014.11.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 11/21/2014] [Indexed: 12/21/2022]
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12
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Rene D, Isidore JOB, Ali K, Gertrude BT, Hadiza IB, Evariste B, T SB, Asseta K, Cheikna Z, Alfred ST, Nicolas B. Serotyping and antimicrobial resistance of enteropathogenic Escherichia coli and enterohemorrhagic E. coli O157 isolated from children under five years of age with diarrhea in rural Burkina Faso. ACTA ACUST UNITED AC 2015. [DOI: 10.5897/ajmr2015.7448] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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13
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Gao L, Hu J, Zhang X, Ma R, Gao J, Li S, Zhao M, Miao Z, Chai T. Dissemination of ESBL-producing Escherichia coli of chicken origin to the nearby river water. J Mol Microbiol Biotechnol 2014; 24:279-85. [PMID: 25277838 DOI: 10.1159/000365786] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The dissemination of drug-resistant bacteria from animal farms to aquatic environments can pose a potential threat to public health. In this study, antimicrobial resistance, resistance genes, and genetic similarity of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli of different origins (chicken feces and upstream and downstream river waters) were analyzed to track the spread of drug-resistant bacteria of animals. The results showed that a total of 29 ESBL-producing E. coli were obtained from 258 samples, and isolation rates of the ESBL-producing E. coli from chicken feces and upstream and downstream waters were 10.7% (16/150), 3.7% (1/27), and 14.8% (12/81), respectively. The ESBL-producing E. coli from upstream water was resistant to 7 antibiotics, but isolates from feces and downstream water had a higher resistance rate. In 29 ESBL-producing E. coli, the most common gene was CTX-M and the SHV gene was not detected. Five ESBL-producing isolates from downstream water showed >90% similarity with the fecal isolates, while the only one isolate from upstream water had <70% similarity with fecal isolates. The results suggest that animal farms' effluent, especially the untreated wastewater, could contribute to the spread of resistance genes.
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Affiliation(s)
- Lili Gao
- College of Animal Science and Veterinary Medicine, Shandong Agricultural University, Jinan, China
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14
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Trends in human fecal carriage of extended-spectrum β-lactamases in the community: toward the globalization of CTX-M. Clin Microbiol Rev 2014; 26:744-58. [PMID: 24092853 DOI: 10.1128/cmr.00023-13] [Citation(s) in RCA: 467] [Impact Index Per Article: 46.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
In the last 10 years, extended-spectrum β-lactamase-producing enterobacteria (ESBL-E) have become one of the main challenges for antibiotic treatment of enterobacterial infections, largely because of the current CTX-M enzyme pandemic. However, most studies have focused on hospitalized patients, though today it appears that the community is strongly affected as well. We therefore decided to devote our investigation to trends in ESBL-E fecal carriage rates and comprehensively reviewed data from studies conducted on healthy populations in various parts of the world. We show that (i) community ESBL-E fecal carriage, which was unknown before the turn of the millennium, has since increased significantly everywhere, with developing countries being the most affected; (ii) intercontinental travel may have emphasized and globalized the issue; and (iii) CTX-M enzymes, especially CTX-M-15, are the dominant type of ESBL. Altogether, these results suggest that CTX-M carriage is evolving toward a global pandemic but is still insufficiently described. Only a better knowledge of its dynamics and biology will lead to further development of appropriate control measures.
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Mshana SE, Matee M, Rweyemamu M. Antimicrobial resistance in human and animal pathogens in Zambia, Democratic Republic of Congo, Mozambique and Tanzania: an urgent need of a sustainable surveillance system. Ann Clin Microbiol Antimicrob 2013; 12:28. [PMID: 24119299 PMCID: PMC3852305 DOI: 10.1186/1476-0711-12-28] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 10/08/2013] [Indexed: 11/25/2022] Open
Abstract
A review of the published and unpublished literature on bacterial resistance in human and animals was performed. Sixty-eight articles/reports from the Democratic Republic of Congo (DRC), Mozambique, Tanzania and Zambia were reviewed. The majority of these articles were from Tanzania. There is an increasing trend in the incidence of antibiotic resistance; of major concern is the increase in multidrug- resistant Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Vibrio cholera, non-typhoid Salmonella and other pathogens responsible for nosocomial infections. The increase in methicillin- resistant Staphylococcus aureus and extended-spectrum beta-lactamase (ESBL) producers in the countries under review confirms the spread of these clones worldwide. Clinical microbiology services in these countries need to be strengthened in order to allow a coordinated surveillance for antimicrobial resistance and provide data for local treatment guidelines and for national policies to control antimicrobial resistance. While the present study does not provide conclusive evidence to associate the increasing trend in antibiotic resistance in humans with the use of antibiotics in animals, either as feed additives or veterinary prescription, we strongly recommend a one-health approach of systematic surveillance across the public and animal health sectors, as well as the adherence to the FAO (Food and Agriculture Organization)-OIE (World Organization of animal Health) –WHO(World Health Organization) recommendations for non-human antimicrobial usage.
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Affiliation(s)
- Stephen E Mshana
- Department of Microbiology/Immunology Weill Bugando School of Medicine, CUHAS-Bugando, Mwanza, Tanzania.
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