Epidemiology of Injuries, Outcomes at a Rural Hospital in Cameroon: Results and Lessons Learned

Journal:

Journal of the West African College of Surgeons

Author(s):

Chao Long

Additional Authors: Moses Kasumba, Jim Brown, Sherry M Wren
Topic(s):
Outcomes and Impact
Training and capacity building
Education
Measurement
Quality Improvement
Follow Up and Outcomes
OPEN PUBLICATION

Objective

The aim of this study was to evaluate the Antibiotic susceptibility profile of Enterococcus spp. isolated from patients with urinary tract infection and health care environment in two Reference Hospitals in Cameroon.

Methodology

Clinical and environmental specimens were collected and cultured in the appropriate culture media: CPS chromogenic medium for urine, bile esculin agar supplemented with vancomycin for stools and bile esculin agar for environmental specimens. The antibiotic susceptibility testing was done using the disk diffusion method as recommended by Antibiotic Committee of French Microbiology Society (CASFM 2013) and the resistance to vancomycin was determined by the agar screen method.

Result

Out of 250 clinical and environmental specimens collected, 50 strains of enterococci were isolated with the most prevalent in the following order: 26 E. faecium, 17 E. faecalis, 4 E. durans, 3 E. avium. Resistance observed in E. faecalis and E. faecium to erythromycin (84)% , ampicillin (60%), cotrimoxazol (42.4)%, tetracycline (41.6)%, vancomycin 28% and teicoplanin (19.2%). Out of the 50 isolates, 7 were resistant to vancomycin (with CMI greater or equal to 4µg/ml) from which 04 were isolated from urine, 02 from environment and one from faeces. Genes Van A, Van B and the phenotypes S and SKG were frequently observed with E. faecium.

Conclusion

Vancomycin enterococci resistance and high level of aminoglycoside resistance (HLAR) lead us to recommend that health policy planners need to reinforce the bacterial resistance committee activities in order to monitor enterococci infections.