(Geneva) Children in sub-Saharan Africa carry bacteria that are multi-resistant to antibiotics in proportions that have become very worrying, particularly due to the abusive use of these drugs, according to two studies from the University Hospitals of Geneva (HUG) and the University of Geneva (UNIGE).
“We observed a high proportion of bacteria resistant to antibiotics, particularly those found in the blood of young patients,” emphasizes Dr. Noémie Wagner, pediatric infectiology specialist at HUG, quoted in a press release.
The first study aimed to assess the proportion of antibiotic-resistant Enterobacteriaceae in children in sub-Saharan Africa during infections.
These bacteria, very frequently found in severe infections, are known for their ability to develop resistance to antibiotics. They are in the digestive tract.
The second study sought to estimate the prevalence of the number of children colonized by enterobacteria resistant to cephalosporins, a 3rd generation antibiotic.
Both studies were based on a systematic review of existing studies and a meta-analysis of the data they contain.
Regarding broad-spectrum cephalosporins, almost a third of the children studied carry resistant enterobacteria.
“However, there are often no other therapeutic options available in this region in the event of failure,” underlines Professor Annick Galetto-Lacour, at the Department of Pediatrics, Gynecology and Obstetrics of the Faculty of Medicine of the UNIGE.
“However, in sub-Saharan Africa, between 83% and 100% of hospitalized children are treated with antibiotics,” the press release highlights. And in addition, almost 54% of children who entered the hospital without carrying resistant enterobacteria came out positive for these bacteria.
Reducing antibiotic resistance requires “strengthening all measures aimed at appropriate use of antibiotics and, on the other hand, limiting the transmission of infections through hygiene measures,” notes Dr. Wagner.
She recommends promoting access to additional examinations to avoid systematically resorting to antibiotics.
But these exams have a cost and are not always available.
However, in sub-Saharan Africa, as bacterial infections are the main cause of death, “children are very frequently treated with antibiotics upon admission to hospital, even in the absence of solid evidence to suspect a bacterial infection,” notes Dr. Wagner.
The NGO Médecin sans frontières has developed a mini-clinical bacteriology laboratory, autonomous, transportable and at an affordable cost, which could help to better target the use of antibiotics.
The most common bacteria are E. coli and Klebsiella spp and the proportion of resistance to antibiotics given in first or second line is “very high”.
For E. coli, they reached 92.5% for ampicillin and 42.7% for gentamicin.
The Klebsiella spp strains, still resistant to ampicillin, presented resistance proportions of 77.6% to gentamicin, the press release highlights.
The enterobacteria analyzed also showed high proportions of resistance to third-generation cephalosporins, which represent the 2nd line of treatment for childhood sepsis, with respectively 40.6% of E. coli and 84.9% of resistant Klebsiella spp samples.