Abstract :
Introduction: Gram-negative bacilli are often responsible for rectal colonization in
children. These bacilli normally sensitive to third generation cephalosporins (3GC)
have acquired disturbing antibiotic resistance in recent years, hence the interest of
our study. The aims are to monitor the epidemiological evolution resistance of
Enterobacteriaceae with antibiotics in particular β-lactams, estimate the prevalence
of enterobacteria responsible for rectal colonization and their resistance to 3GC.
Material and methods: This is a descriptive prospective study of Enterobacteriaceae
in children attending Ambohimiandra Hospital for a period of 3 months (from 01
August to 31 October 2015). We have done a rectal swab of all the children whom
we have parental consent. The samples were processed at the Laboratory of Medical
Biology Faravohitra. The parameters studied are the antecedent of therapy
antibiotic, notion of recent hospitalization and the results of microbiological
examinations. Results: Of the 55 bacteriological samples obtained, 39 strains of
Enterobacteriaceae were isolated, Escherichia coli (n = 12), Enterobacter cloacae (n
= 13), Citrobacter spp (n = 1), Salmonella spp. (N = 5) and Shigella spp (n = 2), Proteus
mirabilis (n = 1). Six isolated strains (50%) of Escherichia coli showed resistance to
ceftriaxone, of which 4 (33.33%) produced ESBL. Conclusion: Gram-negative bacilli
responsible for colonization of the digestive tract have several resistances to β-
lactams, in particular 3GC, by the production of enzymes (Expanded spectrum betalactamase
or ESBL and cephalosporinase or CASE) which hydrolyze these antibiotics.
Measures to combat the spread of these phenomena resistance must be
implemented in the Malagasy community to limit them.
Keyword :
Rectal porous, Gram negative bacillus, ESBL, Multiresistence