Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
Jamot Hospital, Yaoundé, Cameroon.
Biomed Res Int. 2021 May 22;2021:9957112. doi: 10.1155/2021/9957112. eCollection 2021.
Antimicrobial resistance represents a growing public health threat. One of the World Health Organization's strategic objectives is "strengthening knowledge through surveillance and research." Sub-Saharan African countries are still far from achieving this objective. We aimed to estimate and compare the prevalence of antibacterial resistance in 2010 and 2017 in Cameroon.
We conducted a retrospective study on all clinical specimens cultured in Centre Pasteur du Cameroun (CPC) in 2010 and 2017. Data were extracted from the CPC's laboratory data information system software and then managed and analyzed using R. Bacterial resistance rates were calculated in each year and compared using chi-square or Fisher's tests, and relative changes were calculated. Outcomes included acquired resistance (AR), WHO priority resistant pathogens, some specific resistances of clinical interest, and resistance patterns (multi, extensively, and pan drug resistances) for five selected pathogens.
A total of 10,218 isolates were analyzed. The overall AR rate was 96.0% (95% CI: 95.4-96.6). Most of WHO priority bacterial resistance rates increased from 2010 to 2017. The most marked increases expressed as relative changes concerned imipenem-resistant (6.2% vs. 21.6%, +248.4%, = 0.02), imipenem-resistant (13.5% vs. 23.5%, +74.1%, < 0.01), 3rd generation-resistant Enterobacteriaceae (23.8% vs. 40.4%, +65.8%, < 10), methicillin-resistant (27.3% vs. 46.0%, +68.6%, < 0.002), fluoroquinolone-resistant (3.9% vs. 9.5%, +142.9%, = 0.03), and fluoroquinolone-resistant Enterobacteriaceae (32.6% vs. 54.0%, +65.8%, < 10). For selected pathogens, global multidrug resistance was high in 2010 and 2017 (74.9% vs. 78.0% +4.1%, = 0.01), intensively drug resistance rate was 5.8% (7.0% vs. 4.7%; = 0.07), and no pan drug resistance has been identified.
Bacterial resistance to antibiotics of clinical relevance in Cameroon was high and appeared to increase between 2010 and 2017. There is a need for regular surveillance of antibacterial resistance to inform public health strategies and empirically inform prescription practices.
抗生素耐药性是日益严重的公共卫生威胁之一。世界卫生组织的战略目标之一是“通过监测和研究加强知识”。撒哈拉以南非洲国家仍远未实现这一目标。我们旨在估计和比较 2010 年和 2017 年在喀麦隆的抗菌药物耐药率。
我们对 2010 年和 2017 年在喀麦隆巴斯德中心（CPC）培养的所有临床标本进行了回顾性研究。数据从 CPC 的实验室数据信息系统软件中提取，然后使用 R 进行管理和分析。在每年计算细菌耐药率，并使用卡方或 Fisher 检验进行比较，并计算相对变化。结果包括获得性耐药（AR）、世界卫生组织优先耐药病原体、一些临床相关的特定耐药性以及 5 种选定病原体的耐药模式（多药、广泛和泛耐药）。
共分析了 10218 株分离株。总体 AR 率为 96.0%（95%CI：95.4-96.6）。大多数世界卫生组织优先细菌耐药率从 2010 年到 2017 年有所增加。以相对变化表示的最显著增加涉及亚胺培南耐药（6.2%比 21.6%，+248.4%，=0.02）、亚胺培南耐药（13.5%比 23.5%，+74.1%，<0.01）、第三代肠杆菌科耐药（23.8%比 40.4%，+65.8%，<10）、耐甲氧西林金黄色葡萄球菌（27.3%比 46.0%，+68.6%，<0.002）、氟喹诺酮耐药性（3.9%比 9.5%，+142.9%，=0.03）和氟喹诺酮耐药性肠杆菌科（32.6%比 54.0%，+65.8%，<10）。对于选定的病原体，2010 年和 2017 年全球多药耐药率较高（74.9%比 78.0%，+4.1%，=0.01），强化药物耐药率为 5.8%（7.0%比 4.7%，=0.07），未发现泛耐药性。
喀麦隆与临床相关的抗生素耐药性细菌很高，并且在 2010 年至 2017 年间似乎有所增加。需要定期监测抗菌药物耐药性，以制定公共卫生策略并为经验性处方实践提供信息。
