In vitro antibacterial activity of tigecycline against multidrug-resistant bacteria isolated at the Sourô Sanou University teaching hospital in Bobo-Dioulasso, Burkina Faso

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Résumé

Background Tigecycline, an antibiotic effective against multidrug-resistant bacteria (MDRB), remains inaccessible in Burkina Faso’s hospitals for urgent care. Given the resulting therapeutic challenges and mortality in emergency services, evidence-based study of tigecycline’s efficacy on local bacterial clinical isolates is necessary before recommending its use. Objective This study aimed to evaluate the activity of tigecycline on MDRB isolates at the Sourô Sanou University Teaching Hospital laboratory, Burkina Faso. Methods This was a cross-sectional study with prospective and consecutive sampling of MDRBs. The latter included extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E), carbapenem-resistant strains (CRS), and methicillin-resistant Staphylococcus aureus (MRSA), which were isolated from urine, blood, pus and puncture fluids between 01 June 2022 and 31 August 2022. Antimicrobial susceptibility testing was conducted using the modified Kirby-Bauer method, and the results were interpreted according to the standard set by the European Committee on Antimicrobial Susceptibility Testing in 2021. Results A total of 117 MDRBs, including 93 Enterobacterales, 15 carbapenem-resistant Acinetobacter baumannii (CRAB), and 9 MRSAs were collected. The proportion of ESBL-E was 58% (68/117), followed by CRS (34%, 40/117) and MRSA (8%, 9/117). The activity of tigecycline was 95.5% (43/45) on ESBL-E, 72.5% (29/40) on CRS (including 10/15 CRAB), and 89% (8/9) on MRSA. Conclusion The activity of tigecycline was highly effective on ESBL-E, carbapenem resistant Enterobacterales and MRSA, and moderate on CRAB. What this study adds This was the first report on the evaluation of tigecycline activity on MDRBs in Burkina Faso. This non-marketed antibiotic in Burkina Faso could represent an alternative to spare carbapenems in the treatment of ESBL-E infections, and a last resort antibiotic against susceptible CRS infections in Burkina Faso’s hospitals.

Mots-clés

Acinetobacter baumannii; Burkina Faso; Enterobacterales; extended-spectrum β-lactamase-producing Enterobacterales; in vitro; methicillin-resistant Staphylococcus aureus; multidrug-resistant bacteria; tigecycline.