Antimicrobial Resistance Profile of Bacterial Isolates from Urinary Catheter Patients in Abidjan, Côte d'Ivoire

Abstract

Background: Urinary tract infection (UTI) is an inflammation of the bladder caused by an abnormal multiplication of pathogenic microorganisms in the urinary tract. It is often observed in children, adults and the elderly, both men and women, and is one of the main reasons for medical consultation. Consequently, antibiotic resistance continues to be a major public health concern. Aims: Antibiotic resistance in uropathogenic strains is a major public health issue. The aim of this study was to analyse the antibiotic resistance profile of uropathogenic strains obtained from patients using urinary catheters. Methodology: It is a retrospective study. Bacteriology and virology laboratory of Institut Pasteur, Abidjan, Côte d'Ivoire. The techniques applied include phenotypic re-identification of the strains collected, antibiograms to assess bacterial sensitivity, and a synergy test to identify extended-spectrum beta-lactamase production. The double synergy technique this method consists of arranging discs of third-generation cephalosporins (cefotaxime, ceftriaxone and ceftazidime) and aztreonam 30 mm from a central disc containing amoxicillin combined with clavulanic acid, following. Results: 61 strains were collected, with Staphylococcus aureus predominating at 25%, followed by Pseudomonas aeruginosa at 20%. In terms of bacterial response to antibiotics, most of the beta-lactams evaluated showed no activity against Enterobacteriaceae, coagulase-negative Staphylococcus and 46.66% of Staphylococcus aureus, with the exception of imipenem, which showed a low resistance rate of 14.81%. For Pseudomonas aeruginosa isolates, resistance was 58% to both ticarcillin with clavulanic acid and ticarcillin alone. In terms of reaction to aminoglycosides, Escherichia coli and Klebsiella pneumoniae strains showed resistance rates of 78% and 80% respectively, to gentamicin. With ciprofloxacin, all the strains examined showed resistance, with proportions ranging from 46% to 100%. Of these strains, 14 gave positive results in the synergy test, with a rate of 44.26%. Conclusion: These high rates are the result of selection pressure for resistance genes, underlining the importance of an appropriate surveillance policy. The antibiotic resistance profile revealed high levels of resistance to third-generation cephalosporins, and most strains were multidrug-resistant.