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Abstract
Since the prevalence of Enterobacter spp. as a nosocomial pathogen is on the increase and the prevalence of β-lactams resistant strains is on the rise, a study was designed to analyze the diversity and distribution of Enterobacter spp. at the Yaounde General Hospital with regard to biochemical and antibiotic resistance profiles. From December 2006 to August 2007, a prospective study on Enterobacter strains isolated from clinical samples was conducted in the bacteriology laboratory of the Yaounde General Hospital. In addition to phenotypes derived from the commercial biochemical kit API 20E (BioMèrieux), 3 biochemical tests were performed. Antibiotics resistances were determined on Mueller Hinton agar by standard disks diffusion procedures to 12 antibiotics. There was a great variability in biotypes within the species cloacae with 9 distinct biotypes identified. Phenotypes characterized by a high level of resistance (more than 6 antibiotics tested) were present both in community and hospitalized patients. 7 strains of Enterobacter were identified as strains producing extended spectrum betalactamases. For all cephalosporins, the percentages of resistance were greater among hospitalized patients, children and new-borns being the most affected. The resistance were higher in blood cultures than in other samples. The distribution of resistance within the Enterobacter genera was different depending on whether the patient was hospitalized or not, the category of age to which he belongs and the specimen from which the strains were isolated. There was no association between biotypes isolated and the origin or the type of the specimen and the patient’s age.
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References
- Sanders WE and Sanders CC. Enterobacter spp.: Pathogens poised to flourish at the turn of the Century. Clinical Microbiology Review .10, 220-241, 1997.
- Al Ansari N, McNamara EB, Cunney RJ, Flynn MA and Smyth EG. Experience with Enterobacter bactaeremia in a Dublin teaching hospital. Journal of Hospital Infection 27, 69–72, 1994.
- Gaston, MA. Enterobacter: an emerging nosocomial pathogen. Journal of Hospital Infection 11, 197-208, 1988.
- Freitas AL and Barth AL. Typing of Pseudomonas aeruginosa from hospitalized patients: a comparison of susceptibility and biochemical profiles with genotype.Braz J. Med Biol Res. 37(1), 77-82, 2004.
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- Clinical Laboratory Standards Institute.Performance Standards for antimicrobial disc susceptibility testing. 14 th Informational Supplement, 2004.
- Antimicrobial susceptibility testing. TML/MSH Microbiology dept. Policy and procedure manual, 37-41,2001.
- Kühn, I. B., Ayling Smith, K., Tullus, K. and Burman, L. G. The use of colonization rate and epidemic index as tools to illustrate the epidemiology of faecal Enterobacteriaceae strains in Swedish neonatal wards. Epidemiology of Infections. 23: 287-297,1993.
- Paterson, D. L. Resistance in Gram negative bacteria: Enterobacteriaceae. American Journal of Medecine 119: S20-S228, 2006.
- Aibinu, I.E., Ohaegbulam, V.C., Adenipekun, E.A., Ogunsola, F.T., Odugbemi, T.O. and Mee, B.J. Extended-Spectrum β-Lactamase Enzymes in Clinical isolates of Enterobacter Species from Lagos, Nigeria. Journal of Clinical Microbiology 41, 2197-2200, 2003.
- Mkaouar, Mahjoubi, F. Mezghani, S., Znazen, A., Ktari, S. and Hammani, A. Étude de la résistance des entérobactéries de 3e génération dans les hôpitaux de Sfax, Tunisie (1999-2005). Médecine et maladies infectieuses 38(6), 293-298, 2008.
- Griadkowski, M. Evolution and epidemiology of extended spectrum β-lactamases and ESBLs producing microorganisms. Clinical Microbiology Infections 7, 597-608, 2001.
- Von Baum, H. and Marre, R. Antimicrobial resistance of Escherichia coli and therapeutic implication. International Journal of Medical Microbiology 295:503- 51, 2005.
References
Sanders WE and Sanders CC. Enterobacter spp.: Pathogens poised to flourish at the turn of the Century. Clinical Microbiology Review .10, 220-241, 1997.
Al Ansari N, McNamara EB, Cunney RJ, Flynn MA and Smyth EG. Experience with Enterobacter bactaeremia in a Dublin teaching hospital. Journal of Hospital Infection 27, 69–72, 1994.
Gaston, MA. Enterobacter: an emerging nosocomial pathogen. Journal of Hospital Infection 11, 197-208, 1988.
Freitas AL and Barth AL. Typing of Pseudomonas aeruginosa from hospitalized patients: a comparison of susceptibility and biochemical profiles with genotype.Braz J. Med Biol Res. 37(1), 77-82, 2004.
Koneman EW, Allen, S D, Janda WH, Shreckenberger PC, Win WC. The Enterobacteriaceae. In color atlas and textbook diagnostic microbiology 5 th ed. J.B. Lippincott Co. Philadelphia, 210-300, 2006.
API 20E. Identification system for Enterobacteriaceae and others Gram negative rods. Instruction manual version C. Ref 20 100 BioMèrieux 22.
Clinical Laboratory Standards Institute.Performance Standards for antimicrobial disc susceptibility testing. 14 th Informational Supplement, 2004.
Antimicrobial susceptibility testing. TML/MSH Microbiology dept. Policy and procedure manual, 37-41,2001.
Kühn, I. B., Ayling Smith, K., Tullus, K. and Burman, L. G. The use of colonization rate and epidemic index as tools to illustrate the epidemiology of faecal Enterobacteriaceae strains in Swedish neonatal wards. Epidemiology of Infections. 23: 287-297,1993.
Paterson, D. L. Resistance in Gram negative bacteria: Enterobacteriaceae. American Journal of Medecine 119: S20-S228, 2006.
Aibinu, I.E., Ohaegbulam, V.C., Adenipekun, E.A., Ogunsola, F.T., Odugbemi, T.O. and Mee, B.J. Extended-Spectrum β-Lactamase Enzymes in Clinical isolates of Enterobacter Species from Lagos, Nigeria. Journal of Clinical Microbiology 41, 2197-2200, 2003.
Mkaouar, Mahjoubi, F. Mezghani, S., Znazen, A., Ktari, S. and Hammani, A. Étude de la résistance des entérobactéries de 3e génération dans les hôpitaux de Sfax, Tunisie (1999-2005). Médecine et maladies infectieuses 38(6), 293-298, 2008.
Griadkowski, M. Evolution and epidemiology of extended spectrum β-lactamases and ESBLs producing microorganisms. Clinical Microbiology Infections 7, 597-608, 2001.
Von Baum, H. and Marre, R. Antimicrobial resistance of Escherichia coli and therapeutic implication. International Journal of Medical Microbiology 295:503- 51, 2005.