Antibiotic sensitivity profile of Staphylococcus aureus isolated from HIV/AIDS patients presenting with pyoderma, at the Yaounde Central Hospital, Cameroon.

INTRODUCTION: the purpose of this study was to evaluate the in vitro activity of several antibiotics against strains of Staphylococcus aureus isolated from pyoderma in people living with Human Immunodeficiency Virus (HIV), consulting at the day clinic of the Yaoundé Central Hospital. METHODS: this was a prospective, cross-sectional study which was carried out in five months (November 2013-March 2014). Fifty-three (53) pus specimens were collected; from which the isolation of Staphylococcus aureus was made using Chapman agar. Mannitol fermentation, catalase, coagulase and DNase tests were used for species identification. Antibiotic sensitivity of each strain was determined by the agar diffusion method. RESULTS: forty-eight (48) strains of Staphylococcus aureus were isolated (90.56%). A high rate of sensitivity to antibiotics was observed in many strains: vancomycin (100.0%), pristinamycin (100.0%), chloramphenicol (100.0%), oxacillin (97.9%), cefoxitin (97.9%), gentamicin (87.5%), tobramycin (83.3%). However, some strains had strong resistance to penicillin G (89.6%) and cotrimoxazole (64.6%). The proportion of Methicilin Resistant strains of Staphylococcus aureus (MRSA) was low (2.0%). The kanamycin-tobramycin-gentamycin phenotype (KTG) was most common in the aminoglycosides resistant strains; the same as the induced phenotype E stains (iMLSB) in macrolides resistant strains. Conclusion: these results indicate that many of these antibiotics tested are still effective against strains of Staphylococcus aureus.

Viral load testing and the use of test results for clinical decision making for HIV treatment in Cameroon: An insight into the clinic-laboratory interface.

BACKGROUND: The viral load (VL) in patients receiving antiretroviral therapy (ART) is the best predictor of treatment outcome. The anticipated benefits of VL monitoring depend on the actual uptake of VL test results for clinical decisions. The objective of this study was to assess the uptake and utilization of VL test results for clinical decisions on HIV treatment in Cameroon, from 2013 to 2017. METHODS: This was a retrospective cohort analysis of data from files of patients receiving ART at Buea, Limbe, Bamenda and Bafoussam regional hospital HIV treatment centers. A simple random pick of six file blocks was performed in each shelf that corresponded to a year of initiation, and the contents of all selected files were reviewed and the information needed for the study entered a structured questionnaire. The data collected was recorded in Epi Info (version 7.1.5.2), and analyzed using SATA (version 12.1; StataCorp LP). RESULTS: Eight hundred and thirty files were reviewed. The mean duration on ART was 39.4±12 months. Viral load testing uptake was 24.33% and only one VL test had been done by all patients. Approximately 65% of the patients did the first VL after more than 24 months on ART. The median turnaround (TAT) time for VL testing was 6 days (Interquartile range (IQR) 3-7days). Among 201 patients who did a VL test, 94.55% had VL suppression (≤1000copies/mm3). Approximately 54% of the patients with virologic failure were switched to a second-line regimen. CONCLUSIONS: The uptake of viral load testing is low in North West, South West and West Regions of Cameroon. The current TAT for VL testing is plausible. The rate of switch to second line regimen is low. It is time to strengthen the scale up of VL testing and improve the rate of switch to second-line regimen in Cameroon.

Pattern of Antimicrobial Resistance among Bacterial Isolates from Urogenital Clinical Specimens: A Descriptive Study from the Buea Health District, Cameroon.

INTRODUCTION: Antimicrobial resistance has become a global concern and is particularly affecting developing countries where infectious diseases and poverty are endemic. The effectiveness of currently available antimicrobials is decreasing as a result of increasing resistant strains among clinical isolates. OBJECTIVES: The aim of this study was to determine the resistance pattern of bacterial isolates from different clinical urogenital specimens at different hospitals in the Buea Health District, Cameroon. METHODS: A retrospective study was conducted in three hospital laboratories in the Buea Health District, Cameroon, from June to August 2017. All culture and antimicrobial susceptibility test results of patients who presented at each of the laboratories for urine, vaginal swab or urethral swab cultures from January 2012 to December 2016 were included in the study. Data were analysed using SPSS Windows version 20.0. The comparisons between different isolates' resistance to antimicrobials were performed using the chi-square test. The difference in the resistance of urogenital isolates to various antimicrobials within different years was also compared by the chi-square test. RESULTS: A total of 423 bacterial isolates were obtained from clinical urogenital specimens such as: urine 93 (21.9%), vaginal swab 175 (41.4%) and urethral swab cultures 155 (36.6%). The predominant bacterial isolates were Staphylococcus spp. 320 (75.5%), Escherichia coli 37 (8.7%) and Enterococcus spp. 24 (5.7%). All the isolates showed significantly high resistance rates to amoxicillin/clavulanic acid (67.6% resistant rate, p = 0.025), but most isolates, except those of Staphylococcus, were relatively more susceptible to nitrofurantoin (82.6% susceptibility rate, p = 0.045). However, Staphylococcus spp. was more susceptible to ceftriaxone (91.0% susceptibility rate, p < 0.0001) and cefotaxime (74.4% susceptibility rate, p = 0.034). Generally, most of the isolates showed significantly rising rates of resistance to the majority of the antimicrobials tested from 2012 to 2017. CONCLUSION: Our findings showed a progressively rising rate of antimicrobial resistance in urogenital bacterial isolates over the last 5 years in the Buea Health District. Thus, uncontrolled and irrational use or prescription of these drugs should be avoided to maintain low resistance of highly susceptible antimicrobials.