Abstract
Background: The increasing phenomenon of bacterial resistance to antibiotics is a real public health problem. The main causes are poor management of hygiene and water quality, but also the use of antibiotics without precaution. The objective of this study was to isolate and determine the antibiotic resistance profile of the different bacteria found in the main hospitals and bacteriology laboratories in Gabon. Methods: 6034 samples were taken from hospitals in seven main cities of Gabon, and analyzed according to the usual techniques. The pathogenic strains were identified by Matrix-Assisted Laser Desorption Ionization-Time Of Flight Mass Spectrometry. Antimicrobial susceptibility testing was performed by the agar disc diffusion method, according to the Antibiogram Committee of the French Society for Microbiology guidelines. Results: 974 pathogenic bacterial strains were found, including 890/974 (91.4%) Gram-negative bacilli. The systematic antimicrobial susceptibility testings identified 160/974 (16.4%) multi-resistant strains. Escherichia coli was the most represented species. 12.5% - 25% of Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, and Citrobacter sedlakii strains were resistant to amoxicillin + clavulanic acid, third and fourth generation cephalosporins. Aminoglycoside resistance rates of 8.5% - 19% were also noted. 4.5% to 25% of the bacteria found were resistant to quinolones and cotrimoxazole. Resistance rates to carbapenems ranged from 1% to 10.5%. 16% of Staphylococcus aureus were methicillin-resistant (MRSA). Rates of extended spectrum beta-lactamase-producing enterobacteriaceae (ESBL-PE) ranged from 2.5% to 25%. Conclusion: This study showed an increasing evolution of bacterial resistance to antibiotics that are spreading throughout Gabon. This constitutes a threat to the health of Gabonese population.
Highlights
Antibiotics have significantly reduced mortality due to bacterial infectious diseases during the 20th century
This study showed an increasing evolution of bacterial resistance to antibiotics that are spreading throughout Gabon
In Gabon, there are poor data on the epidemiology of resistance at a national level, despite some studies on antimicrobial resistance [2] [8] [15] [16]. Based on these observations and background, we propose for the first time to conduct a prospective study in the main cities of Gabon, outlining a national map of the prevalence of bacterial resistance to antibiotics
Summary
Antibiotics have significantly reduced mortality due to bacterial infectious diseases during the 20th century. The remarkable efficacy of these molecules has motivated their massive and repeated use in human and animal health. This created selection pressure on bacteria, resulting in the emergence of resistance [1]. Beta-lactams are the molecules of choice for the treatment of bacterial infections. Their systematic and abusive use has led to resistance to these antibiotics. The objective of this study was to isolate and determine the antibiotic resistance profile of the different bacteria found in the main hospitals and bacteriology laboratories in Gabon. The systematic antimicrobial susceptibility testings identified 160/974 (16.4%) multi-resistant strains. Escherichia coli was the most represented species. 12.5% - 25% of Escherichia coli, Klebsiella pneu-
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