• Antibiotic Sensitivity of Endemic Shigella in Mbarara, Uganda.

      Legros, D; Ochola, D; Lwanga, N; Guma, G; Epicentre, Kampala, Uganda. (1998-03)
      We analysed the chimio-sensitivity to antibiotics of endemic strains of Shigella isolated in Mbarara district, southwest Uganda. Twenty four strains were isolated, of which none was sensitive to cotrimoxazole and eight (33.4%, 95% CI [15.6-55.3]) to ampicillin, the two antibiotics recommended to treat dysentery during non epidemic periods in Uganda. Two isolates were resistant to nalidixic acid and none was resistant to the fluoroquinolones (Ciprofloxacin, Norfloxacin). It is concluded that the results of this survey could be used to facilitate the elaboration of a new treatment protocol to treat endemic dysentery cases in Uganda.
    • Changes in Escherichia coli resistance to co-trimoxazole in tuberculosis patients and in relation to co-trimoxazole prophylaxis in Thyolo, Malawi.

      Zachariah, R; Harries, A D; Spielmann M P; Arendt, V; Nchingula, D; Mwenda, R; Courteille, O; Kirpach, P; Mwale, B; Salaniponi, F M L; et al. (Elsevier, 2008-01-31)
      In Thyolo district, Malawi, an operational research study is being conducted on the efficacy and feasibility of co-trimoxazole prophylaxis in preventing deaths in HIV-positive patients with tuberculosis (TB). A series of cross-sectional studies were carried out in 1999 and 2001 to determine (i) whether faecal Escherichia coli resistance to co-trimoxazole in TB patients changed with time, and (ii) whether the resistance pattern was different in HIV-positive TB patients who were taking co-trimoxazole prophylaxis. Co-trimoxazole resistance among E. coli isolates in TB patients at the time of registration was 60% in 1999 and 77% in 2001 (P < 0.01). Resistance was 89% among HIV-infected TB patients (receiving cotrimoxazole), while in HIV-negative patients (receiving anti-TB therapy alone) it was 62% (P < 0.001). The study shows a significant increase of E. coli resistance to co-trimoxazole in TB patients which is particularly prominent in HIV-infected patients on co-trimoxazole prophylaxis. Since a high degree of plasmid-mediated transfer of resistance exists between E. coli and the Salmonella species, these findings could herald limitations on the short- and long-term benefits to be expected from the use of co-trimoxazole prophylaxis in preventing non-typhoid Salmonella bacteraemia and enteritis in HIV-infected TB patients in Malawi.
    • Clinical, Microbiological and Antibiotic Susceptibility Patterns of Diarrhoea in Korem, Ethiopia.

      Desenclos, J C; Zergabachew, A; Desmoulins, B; Chouteau, L; Desve, G; Admassu, M; Médecins sans Frontières, Paris, France. (1988-12)
      Two hundred patients with diarrhoea in a rehabilitation camp in Ethiopia were studied in October 1985 to determine the presence of pathogens in the stool and their susceptibility to antibiotics. A total of 42 (21.1%) patients had a positive culture with enterobacteriaceae, the isolation rate was 15.6% for Escherichia coli, 3.5% for Shigella spp. and 2.01% for Salmonella spp. In-vitro antibiotic resistance was frequent among the 42 isolates: 53% of E. coli strains were found to be resistant to ampicillin, 47% to chloramphenicol, 30% to co-trimoxazole and 67% to tetracycline. Of the seven Shigella, three were resistant to chloramphenicol and four to tetracycline. Multidrug resistance (two or more antibiotics) was observed in 52.3% of the 42 isolates. The protocols used for the screening of dysenteric patients for Shigella spp. or Salmonella spp. were found to be specific but poorly sensitive. The opposite was observed for amoebiasis and giardiasis. The responsibility of widespread use of common oral antibiotics is discussed as one of the major factors of antibiotic resistance occurrence at Korem.
    • Use of filter paper as a transport medium for laboratory diagnosis of cholera under field conditions

      Page, Anne-Laure; Alberti, Kathryn P; Guénolé, Alain; Mondongue, Vital; Lonlas Mayele, Sylvaine; Guerin, Philippe J; Quilici, Marie-Laure; Epicentre, Paris, France; Institut Pasteur, Centre National de Reference des Vibrions et du Cholera, Unite des Bacteries Pathogenes Enteriques, Paris, France; Ministry of Health, Kinshasa, Democratic Republic of Congo; Medecins Sans Frontieres, Brussels, Belgium; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom (American Society for Microbiology, 2011-06-22)
      Confirmation of a cholera epidemic is based on bacteriological identification of the agent and requires the sending of samples to a culture laboratory, often in countries with limited resources. Comparison of the use of filter paper with the use of Cary-Blair reference medium for stool transport showed that this simple transport medium is appropriate for the recovery of Vibrio cholerae.