Main Article Content
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
Article Details
References
- REFERENCE
- Lennete, E. H., Balows A., Hausler Jr. W. J., and Shadomy H. J., (1985). Manual of clinical microbiology, fourth edition. Washington D. C: American Association of Microbiology Press. 1985; 263-277.
- Shah. A. A., F. Hasan and A. Hameed. 2002. Study on the prevalence of enterobacteriacae in hospital acquired and community acquired infections. Pakistan J. Med. Res. 41(1)
- Bager F. and Helmuth R. (2001). Epidemiology of resistance to quinolones in Salmonella Vet. Res. 32: 285–290
- Minh Vien L. T., Baker S., Thao L. T. P., Tu L. T.P., Thuy C. T., Nga T. T. T., Minh Hoang N. V. M., Campbell J. I., Yen L. M., Hieu N. T., Chau N. V. V., Farrar J., and Schultsz C. (2009). High prevalence of plasmid-mediated quinolone resistance determinants in commensal members of the enterobacteriaceae in Ho Chi Minh City, Vietnam. Journal of Medical Microbiology. 58; 1585-1892
- Livermore, D. M., James D., Reacher M., Graham C., Nichols T., Stephens P., Johnson A. P., and George R. C.,. (2002). Trends in fluoroquinolones Resistance in Enterobacteriaceae from Bacteremias, England and Wales, 1990-1999 Ciprofloxacin Research. Emerging Infectious Diseases. 8(5): 473-478
- Larouche G. (2001). Les Quinolone: Des Annees Soixante á Aujourd’hui. Pharmatuel 34(2): 40-46
- Eric Scholar M. (2002). Fluoroquinolones: Past, Present, and Future of Novel Group of Antimicrobial Agents. American Journal of Pharmaceutical Education, Summer 2002
- Kerr K. G. (2004). Quinolone Antimicrobial Agent 3rd Ed. Journal of Clinical Pathology. 57; 896-902
- Lautenbach E., Strom B., L, Nachamkin I., Bilker W. B., Marr A. M., Lori A. Larosa, and Neil O. F., (2004). Longitudinal Trends in Fluoroquinolone Resistance among Enterobacteriaceae Isolates from Inpatients and Outpatients, 1989–2000: Differences in the Emergence and Epidemiology of Resistance across Organisms. Clinical Infectious Diseases. 38:655–62
- Leistevuo T., Toivonen P, Osterblad M., Kuistila M., Kahra A., Lehtonen A., and Huovinen P. (1996). Problem of antimicrobial resistance of fecal aerobic Gram-Negative Bacilli in Elderly. Antimicrobial agents and chemotherapy.40(10): 2399-2403
- Chen X., Pan W., Zhang W., Pan Z., Gao S., and Jiao X., (2011). Quinolone resistance in Escherichia coli and Salmonella spp. Isolates from diseased chickens during 1993-2008. African Journal of Microbiology Research Vol. 5(19) 3078-3083
- Clincal Laboratory Standard Institute (2007). Performance Standards For Antimicrobial Susceptibility Testing, 17th Informational Supplement, M100-S17. Wayne, PA: Clinical and Laboratory Standards Institute.
- Momoh A.R., Odike M.A.C., Olowo S., Momoh A.A. Okolo. (2007). Resistance pattern of Urinary tract infection Bacterial Isolate to selected quinolones. African Journals Online. 9(12)22
- Horhat F, Muntean D., Hogea E., Horhat D., Craciunescu M., Licker M., Rosca A.,, Baditoiu L. M., Moldovan R.,. (2010). Quinolone Resistant Enterobacteriaceae Strains Isolated from Urinary Tract Infections in the Intensive Care Unit. Journal of Experimental Medical & Surgical Research. 4: 308 – 310
- Namboodiri S. S., Opintan J. A., Lijek R. S., Newman M. J and Okeke I. N. (2011). Quinolone Resistance in Escherichia coli from Accra Ghana. BMC Microbiology 11:44 doi:10.1186/1471-2180-11-44
- Piddock LJ., Hall MC., Walters RN., (1991). Phenotypic Characterization of quinolone-resistant mutants of enterobacteriacece selected from wild type, gyr A and multiple-resistant (mar A) type strains. J. Antimicrob. Chemoter. 28(2):185-98
- Skandami-Epitropaki V., Xanthaki A., Tsiringa A. Fotiou P., Kontou CHA, Toutoua M. (2008). Fluoroquinolones resistance in Enterobacteriaceae strains isolated from community acquired urinary tract infections. European Society of Clinical Microbiology and Infectious Diseases. 2008; 8.
- 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. (2010). Quinolone and fluorquinolone resistance in Enterobacteriaceae isolated from hospitalised and community patients in Cameroon. Journal of Medicine and Medical Sciences. 1(10): 490-494.
- Hopkins KL, Davis RH., Threlf fall EJ. (2005). Mechanisms of Quinolone Resistance in E. coli and Salmonella: Recent developments. Int. J. Antimicrobial Ag., 25: 358-373
- Bazile-Pham-Khac S., Truong Q. C., Lafont J-P., Gutmann L., Zhou X. Y., Osman M. and Moreau N.J. 1996. Resistance to Fluoroquinolones in Escherichia coli Isolated from Poultry. Antimicrobial agents and chemotherapy. 40(6): 1504-1507
- Gallini A., Degris E., Desplas M., Bourrel R., Archambaud M., Montastruc J-L., Lapeyre-Mestrs M. and Sommet. (2010). Influence of fluoroquinolone consumption in inpatients and outpatients on ciprofloxacin-resistant Escherichia coli in a University Hospital. J of Antimicrobial Chemother. 65:2650-2657
References
REFERENCE
Lennete, E. H., Balows A., Hausler Jr. W. J., and Shadomy H. J., (1985). Manual of clinical microbiology, fourth edition. Washington D. C: American Association of Microbiology Press. 1985; 263-277.
Shah. A. A., F. Hasan and A. Hameed. 2002. Study on the prevalence of enterobacteriacae in hospital acquired and community acquired infections. Pakistan J. Med. Res. 41(1)
Bager F. and Helmuth R. (2001). Epidemiology of resistance to quinolones in Salmonella Vet. Res. 32: 285–290
Minh Vien L. T., Baker S., Thao L. T. P., Tu L. T.P., Thuy C. T., Nga T. T. T., Minh Hoang N. V. M., Campbell J. I., Yen L. M., Hieu N. T., Chau N. V. V., Farrar J., and Schultsz C. (2009). High prevalence of plasmid-mediated quinolone resistance determinants in commensal members of the enterobacteriaceae in Ho Chi Minh City, Vietnam. Journal of Medical Microbiology. 58; 1585-1892
Livermore, D. M., James D., Reacher M., Graham C., Nichols T., Stephens P., Johnson A. P., and George R. C.,. (2002). Trends in fluoroquinolones Resistance in Enterobacteriaceae from Bacteremias, England and Wales, 1990-1999 Ciprofloxacin Research. Emerging Infectious Diseases. 8(5): 473-478
Larouche G. (2001). Les Quinolone: Des Annees Soixante á Aujourd’hui. Pharmatuel 34(2): 40-46
Eric Scholar M. (2002). Fluoroquinolones: Past, Present, and Future of Novel Group of Antimicrobial Agents. American Journal of Pharmaceutical Education, Summer 2002
Kerr K. G. (2004). Quinolone Antimicrobial Agent 3rd Ed. Journal of Clinical Pathology. 57; 896-902
Lautenbach E., Strom B., L, Nachamkin I., Bilker W. B., Marr A. M., Lori A. Larosa, and Neil O. F., (2004). Longitudinal Trends in Fluoroquinolone Resistance among Enterobacteriaceae Isolates from Inpatients and Outpatients, 1989–2000: Differences in the Emergence and Epidemiology of Resistance across Organisms. Clinical Infectious Diseases. 38:655–62
Leistevuo T., Toivonen P, Osterblad M., Kuistila M., Kahra A., Lehtonen A., and Huovinen P. (1996). Problem of antimicrobial resistance of fecal aerobic Gram-Negative Bacilli in Elderly. Antimicrobial agents and chemotherapy.40(10): 2399-2403
Chen X., Pan W., Zhang W., Pan Z., Gao S., and Jiao X., (2011). Quinolone resistance in Escherichia coli and Salmonella spp. Isolates from diseased chickens during 1993-2008. African Journal of Microbiology Research Vol. 5(19) 3078-3083
Clincal Laboratory Standard Institute (2007). Performance Standards For Antimicrobial Susceptibility Testing, 17th Informational Supplement, M100-S17. Wayne, PA: Clinical and Laboratory Standards Institute.
Momoh A.R., Odike M.A.C., Olowo S., Momoh A.A. Okolo. (2007). Resistance pattern of Urinary tract infection Bacterial Isolate to selected quinolones. African Journals Online. 9(12)22
Horhat F, Muntean D., Hogea E., Horhat D., Craciunescu M., Licker M., Rosca A.,, Baditoiu L. M., Moldovan R.,. (2010). Quinolone Resistant Enterobacteriaceae Strains Isolated from Urinary Tract Infections in the Intensive Care Unit. Journal of Experimental Medical & Surgical Research. 4: 308 – 310
Namboodiri S. S., Opintan J. A., Lijek R. S., Newman M. J and Okeke I. N. (2011). Quinolone Resistance in Escherichia coli from Accra Ghana. BMC Microbiology 11:44 doi:10.1186/1471-2180-11-44
Piddock LJ., Hall MC., Walters RN., (1991). Phenotypic Characterization of quinolone-resistant mutants of enterobacteriacece selected from wild type, gyr A and multiple-resistant (mar A) type strains. J. Antimicrob. Chemoter. 28(2):185-98
Skandami-Epitropaki V., Xanthaki A., Tsiringa A. Fotiou P., Kontou CHA, Toutoua M. (2008). Fluoroquinolones resistance in Enterobacteriaceae strains isolated from community acquired urinary tract infections. European Society of Clinical Microbiology and Infectious Diseases. 2008; 8.
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. (2010). Quinolone and fluorquinolone resistance in Enterobacteriaceae isolated from hospitalised and community patients in Cameroon. Journal of Medicine and Medical Sciences. 1(10): 490-494.
Hopkins KL, Davis RH., Threlf fall EJ. (2005). Mechanisms of Quinolone Resistance in E. coli and Salmonella: Recent developments. Int. J. Antimicrobial Ag., 25: 358-373
Bazile-Pham-Khac S., Truong Q. C., Lafont J-P., Gutmann L., Zhou X. Y., Osman M. and Moreau N.J. 1996. Resistance to Fluoroquinolones in Escherichia coli Isolated from Poultry. Antimicrobial agents and chemotherapy. 40(6): 1504-1507
Gallini A., Degris E., Desplas M., Bourrel R., Archambaud M., Montastruc J-L., Lapeyre-Mestrs M. and Sommet. (2010). Influence of fluoroquinolone consumption in inpatients and outpatients on ciprofloxacin-resistant Escherichia coli in a University Hospital. J of Antimicrobial Chemother. 65:2650-2657