Changing profile and increasing antimicrobial resistance of uropathogenic bacteria in Madagascar

We wanted to update the distribution of community-acquired uropathogens and to estimate their susceptibility profile to newly available antibiotics in Antananarivo (Madagascar).

We conducted a 3-year preliminary study (2011-2013) on bacteria isolated from the urine of patients at the Laboratory of Training and Research in Medical Biology (Antananarivo).

Three hundred and fifty-seven pathogens were isolated: 234 (65.55%) Gram-negative bacilli and 123 (34.45%) Gram-positive cocci. The most commonly isolated bacteria were Escherichia coli (89 strains) followed by Staphylococcus aureus (48 strains). Thirty-three percent of Gram-negative bacilli were resistant to 3 CG. Forty percent of Klebsiella pneumoniae strains were significantly resistant to imipenem (P = 0.01).

The increased resistance to newly available antibiotics and the increased rate of Gram-positive cocci strains require a drastic surveillance of antibiotic resistance to ensure appropriate empirical treatment.