Antimicrobial susceptibility of Enterobacteriaceae causing urinary tract infections in Africa: evaluation of the evidence.
Antimicrob Agents Chemother. 2013 May 20;
Authors: Tansarli GS, Athanasiou S, Falagas ME
Objectives:To evaluate the antimicrobial susceptibility of Enterobacteriaceae causing urinary tract infections (UTIs) in adults in Africa.Methods:PubMed database was systematically searched to identify relevant studies published after 2000. Google, World Health Organization, and African Field Epidemiology networks were also searched.Results:Twenty-nine studies accounting for 382,001 urine isolates from 14 African countries met the inclusion criteria. Escherichia coli, Klebsiella spp. and Proteus spp. were the most commonly encountered uropathogens. Cefotaxime, imipenem, fosfomycin and ciprofloxacin were the antibiotics with the highest activity against E. coli isolates from outpatients with susceptibility being 92-99%, 100%, 100% and from 68-91% for each antibiotic, respectively. The susceptibility among Klebsiella spp. isolates from outpatients varied from 80% to 100% for amikacin and from 53% to 100% for ciprofloxacin, while that was 74-78%, 97% and 77% for ciprofloxacin, amikacin, and fosfomycin respectively among Klebsiella spp. isolates from inpatients or patients with hospital-acquired UTIs. With regard to Proteus spp., the highest activity was observed among fluoroquinolones; 71-100% of the P. mirabilis isolates were susceptible to ciprofloxacin in four studies and 74-100% of the P. vulgaris isolates were susceptible to ofloxacin in two studies.Conclusion:The currently available evidence suggests that the antimicrobial susceptibility patterns of Enterobacteriaceae uropathogens in African countries were quite similar to those in countries of Southeastern Europe. Further original studies are warranted to from African countries with limited published data.
PMID: 23689709 [PubMed - as supplied by publisher]