A Comparative Study on Susceptibility of Enterobacteriaceae to Six Quinolones in Yaounde

Emilia Lyonga, Michel Toukam, Julius Atashili, Hortense Gonsu, Dieudonné Adiogo, Martha Mesembe, Georges Nguefack-Tsague, Agnes Eyoh, George Ikomey, Bertha Mukwele, Josian-Myriam Meli-Tiabou, Marie-Claire Okomo-Assoumou

Abstract


Introduction

Enterobactericeae are associated with many types of infections including abscesses, pneumonia, meningitis, septicaemia, and intestinal, urinary and wound infections. Fluoroquinolones (FQs) represent the drug of choice for the treatment of a wide range of human infectious diseases caused by enterobacteriaceae. This study aims at comparing the susceptibility of six quinolones (Qs) of different generations that are often used in the empirical treatment of cases of suspected enterobacterial infections where susceptibility testing is not always systematic.

 

Methodology                                                                                                               

Three hundred enterobacteriaceae species were isolated from 13 different clinical specimens. Identification was done using Api 20E.  Susceptibility testing was performed using the Kirby Bauer Disc Diffusion method using two Qs of first generation; nalidixic acid and pipemidic acid, and four FQs; two second generation; norfloxacin and ciprofloxacin, one third generation; sparmofloxacin and one fourth generation; moxifloxacin.

 Results

The resistance of the different species to the first generation Qs was: Klepsiella 38/99(38.4%); Escherichia 38/108(35.2%); Enterobacter 7/24(29.8%); Proteus 5/24(20.8%); Serratia 6/21(28.6%); Salmonella 1/9(11.1%); Citrobacter 1/8(12.5%). The resistance to the FQs was: Klepsiella 31/99(31.3%); Escherichia 30/108(27.8%); Enterobacter 4/24(16.7%); Proteus 2/24(8.3%); Serratia 6/21(28.6%); Salmonella 0% and Citrobacter 1/24(12.5%); Overall, 99/300(33.0%) of isolates were resistant to the Qs and 77/300(25.7) to the FQs (P-value 0.05).

 Conclusion

This study has shown that overall there is no significant difference in the susceptibility between the Qs of the first generation and the FQs in the treatment of enterobacterial infections. The high of percentage quinolone resistance makes it necessary for us to use a rational in prescribing these drugs. 

RESUME

 

Introduction

Les Entérobactéries sont associées à plusieurs types d’infections incluant les abcès, les pneumonies, les méningites, les septicémies et les infections intestinales, urinaires et des plaies. Les Fluoroquinolones (FQs) représentent le remède de choix dans le traitement d’une large gamme de maladies infectieuses humaines causées par les entérobactéries. Cette étude a pour but de comparer la sensibilité de six quinolones (Qs) de différentes générations qui sont très souvent utilisées dans le traitement empirique des cas suspects d’infections entérobactériennes où l’étude de la sensibilité aux antibiotiques n’est pas toujours systématique.

 

Methodologie                                                                                                               

Trois cent espèces d’entérobactéries ont été isolées à partir de 13 types d’échantillons cliniques. L’identification a été faite en utilisant Api 20E(Biomérieux). La sensibilité aux antibiotiques a été faite en utilisant la méthode de diffusion des disques de Kirby Bauer. Nous avons utilisé deux Qs de première génération : acide nalidixique et acide pipémidique, et quatre FQs : deux de deuxième génération : norfloxacine et ciprofloxacine, un de troisième génération : la sparmofloxacine et une de quatrième génération : la moxifloxacin.

 Résultats

La résistance des différentes espèces aux Qs de première génération était : Klebsiella 38/99(38.4%); Escherichia 38/108(35.2%); Enterobacter 7/24(29.8%); Proteus 5/24(20.8%); Serratia 6/21(28.6%); Salmonella 1/9(11.1%); Citrobacter 1/8(12.5%). La résistance aux FQs était: Klebsiella 31/99(31.3%); Escherichia 30/108(27.8%); Enterobacter 4/24(16.7%); Proteus 2/24(8.3%); Serratia 6/21(28.6%); Salmonella 0% et Citrobacter 1/24(12.5%); En tout, 99/300(33.0%) des isolats étaient résistants aux Qs et 77/300(25.7) aux FQs (P-value 0.05).

 Conclusion

Cette étude a montré que dans l’ensemble, il n’y a pas de différence significative de sensibilité entre les Qs de première génération et les FQs dans le traitement des infections entérobactériennes. Le taux élevé des résistances des quinolones rend nécessaire la prescription rationnelle de ces médicaments.


Keywords


Key Words: Quinolones, Fluoroquinolone, Resistance, Enterobacteriaceae

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