Swiss researchers have revealed alarming figures on the high proportions of South African children carrying bacteria that are multi-resistant to antibiotics.
- Antibiotic resistance is when bacteria are able to resist the action of an antibiotic.
- Swiss researchers have identified very high proportions of children carrying multidrug-resistant bacterial strains in sub-Saharan Africa.
- According to the results of this work, approximately 32.2% of children were carriers of enterobacteria resistant to broad-spectrum cephalosporins, a class of antibiotics.
“Antibiotic resistance is today one of the most serious threats to global health, food security and development,” had alerted World Health Organization (WHO) in 2020. Antibiotic resistance refers to the ability of a bacterium to resist the action of an antibiotic.
In sub-Saharan Africa, this issue is particularly significant. This country has the highest rate of deaths attributed to antibiotic resistance, particularly among children and newborns. Two studies, conducted by the Geneva University Hospitals (HUG) and the University of Geneva (UNIGE), have observed very high rates of children carrying multi-resistant bacterial strains. This work was published in the journal The Lancet.
92.5% resistance to ampicillin
In the first study, scientists estimated the proportion of enterobacteria, present in the digestive tract, that were resistant to antibiotics in children in sub-Saharan Africa.
High rates of resistance to ampicillin and gentamicin, two antibiotics often prescribed for sepsis, were observed in children, with rates reaching 92.5% for ampicillin and 42.7% for gentamicin, respectively, in E. coli infection. “The strains of Klebsiella spp, always resistant to ampicillin, showed resistance proportions of 77.6% to gentamicin. The Enterobacteria analyzed also showed high proportions of resistance to third-generation cephalosporins, which represent the 2nd line of treatment for sepsis [septicémie] of children, with respectively 40.6% of E. coli samples and 84.9% of Klebsiella spp samples resistant. These results therefore suggest a very high proportion of resistance to the antibiotics recommended in first and second lines for septicemia in children”we can read in a statement.
In the second study, the Swiss teams assessed the prevalence of the number of children colonized by enterobacteria resistant to third-generation cephalosporins. “The term colonization refers to the finding of bacteria in a child’s stool, without an existing infection.”the researchers said. The work showed that 53.8% of children who entered the hospital without being carriers of resistant enterobacteria tested positive for these bacteria.
In a cohort of 9,408 children, approximately 32.2% carried Enterobacteriaceae resistant to broad-spectrum cephalosporins. “These proportions are very high and worrying. In fact, these treatments are given as second-line treatments when first-line treatments have failed. However, there are often no other therapeutic options available in this region in the event of failure.”warned Professor Annick Galetto-Lacour, responsible for the two meta-analyses, associate physician at the HUG Pediatric Reception and Emergency Department.
Excessive use of antibiotics
In sub-Saharan Africa, bacterial infections are the leading cause of death. Between 83% and 100% of hospitalized children are treated with antibiotics in this region even in the absence of evidence that the infection is bacterial. “In sub-Saharan Africa, most medical facilities do not have access to inflammatory markers that can help distinguish a bacterial infection, requiring antibiotics, from a viral infection. They also do not have the ability to perform cultures and therefore cannot correctly identify bacterial species or perform antimicrobial susceptibility tests. It is the snake biting its own tail, because the overuse of antibiotics increases the proportion of resistant bacteria that will be more difficult to treat.”stressed Dr. Noémie Wagner, associate physician at the HUG Pediatric Infectious Diseases Unit. For the researchers, these results prove the need for targeted actions to manage and regulate antibiotic resistance. in sub-Saharan Africa.
