1. Antimicrobial resistance in pathogens causing nosocomial infections in surgery and intensive care units of two hospitals in Antananarivo, Madagascar
- Author
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Jean Roger Raveloson, Armand Rakotoarijaona, Vincent Richard, Laetitia Vaillant, Jules Randrianomenjanahary, Elisoa Ratsima Hariniana, Frédérique Randrianirina, Jean-François Carod, Mamy Lalatiana Andriamanarivo, Henri Claude Razafimahandry, C.E. Ramarokoto, Antoine Talarmin, Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP), Hôpital Joseph Ravoahangy Andrianavalona, Centre Hospitalier Soavinandriana, Centre hospitalier Soavinandriana, and We would like to thank all the physicians and staff for their cooperation in this study, particularly Dr Samson Luc Hervé, Dr Rakoto-Ratsimba Herinirina, Dr Rakotosamimanana Johnny, Dr Tsiaviry Persisy, Dr Solofomalala Gaëtan Duval, Dr Rasolofondranoatra Helivao, Dr Ramarokoto, and Dr Godard Tovone.
- Subjects
Male ,Klebsiella ,[SDV]Life Sciences [q-bio] ,Antibiotics ,Drug resistance ,intensive care wards ,medicine.disease_cause ,MESH: Madagascar ,0302 clinical medicine ,Anti-Infective Agents ,Risk Factors ,MESH: Risk Factors ,030212 general & internal medicine ,2. Zero hunger ,Cross Infection ,0303 health sciences ,biology ,Bacterial Infections ,General Medicine ,Enterobacter ,bacterial resistance ,Drug Resistance, Multiple ,3. Good health ,Acinetobacter baumannii ,Intensive Care Units ,Infectious Diseases ,nosocomial infection ,Female ,medicine.medical_specialty ,Critical Care ,MESH: Bacterial Infections ,medicine.drug_class ,MESH: Anti-Infective Agents ,Microbiology ,MESH: Multivariate Analysis ,MESH: Drug Resistance, Multiple ,03 medical and health sciences ,MESH: Cross-Sectional Studies ,Antibiotic resistance ,Virology ,Intensive care ,Drug Resistance, Bacterial ,MESH: Drug Resistance, Bacterial ,Madagascar ,medicine ,Humans ,MESH: Intensive Care ,MESH: Humans ,Bacteria ,030306 microbiology ,Pseudomonas aeruginosa ,business.industry ,MESH: Cross Infection ,biology.organism_classification ,MESH: Male ,Surgery ,MESH: Bacteria ,Cross-Sectional Studies ,Multivariate Analysis ,MESH: Intensive Care Units ,Parasitology ,business ,MESH: Female ,surgery wards - Abstract
Background: In developing countries, knowledge of antimicrobial resistance patterns is essential to define empirical therapy. Methodology: All the surgery and intensive care wards of two hospitals in Antananarivo were included to study the antimicrobial susceptibility of the pathogenic bacteria causing nosocomial infections. A repeated cross-sectional survey was conducted between September 2006 and March 2008, one day per week. Isolates were identified using classical methods, and resistance to antibiotics was assessed according to the recommendations of the Antibiogram Committee of the French Microbiology Society. Results: Clinical specimens from 706 from 651 patients were collected. Of the 533 bacterial pathogens, 46.7% were Enterobacteriaceae , 19.3% were Staphylococcus aureus , and 19.1% were pathogens from the hospital environment ( Pseudomonas aeruginosa and Acinetobacter baumannii ).Frequencies of resistance were high, particularly in Enterobacteriaceae ; however, the rate of Staphylococcus aureus isolates resistant to oxacillin (13.6 %) was moderate and all these isolates were susceptible to glycopeptids. The percentages of isolates susceptible to ceftazidim were 81.8% for E. coli , 60.9% for Klebsiella , and 52.5% for Enterobacter spp. Resistance to third-generation cephalosporins was due to extended spectrum betalactamases (ESBL). Multivariate analysis showed that diabetes (adjusted OR: 3.9) and use of an invasive procedures (adjusted OR: 3.5) were independent risk factors for resistance to third-generation cephalosporins. Conclusion: A nationwide surveillance programme is needed to monitor the microbial trends and antimicrobial resistance in Madagascar.
- Published
- 2009
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