Modeling the Antimicrobial Resistance of Enterobacteria Responsible for Urinary Tract Infections in Benin: Another Way to Control Antimicrobial Resistance

Background: Infectious diseases are serious public health issue both in developing countries and industrialized nations. In developing countries, they are the main cause of high mortality rates. In the second group, existing resistance strains to antibiotics is developing and growing at an alarming rate. The purpose of this study was to produce data of national interest to implement sustainable control program against the spread of antimicrobial resistance strains in Benin.

Methods: One hundred and ninety (190) urine samples were collected in selected hospitals in Benin from patients with urinary tract infection. After getting the informed consent from the patients, samples collections were performed under aseptic conditions and cultured for further analysis in the laboratory. The resistance profile of the bacterial strains was established. The search for beta-lactamase production by the isolates was performed using the synergy test for amoxicillin/clavulanic acid and cephalosporins. Mathematical modeling for predicting the development of resistance of the strains by the year 2024 was carried out employing the compartmental deterministic models.

Results: Two hundred and thirty (230) strains were identified from the urine samples. Male individuals were the most affected by urinary tract infections. Individuals between the ages of 21-30 were predominantly infected. E. coli was the most isolated species (32.43%) in the urine samples, followed by K. pneumoniae (26.85%) and E. cloacae (25.92%). The susceptibility testing of isolates showed a high resistance to amoxicillin (91.82%). Whereas the lowest resistance was to imipenem (2%). The beta-lactamase was produced by 24.03% of the strains. Escherichia coli (32.43%) was the most productive of broad spectrum beta-lactamase, followed by K. pneumoniae (31.03%). The mathematical modeling revealed a rampant rise in resistance development of the strains to the tested antibiotics.

Conclusions: These results provide important data for developing new preventive strategies against the evolution of bacterial resistance to antibiotics. It therefore, further deserves a constructive advocacy so that more actions are taken against the rampant spread of antimicrobial resistance strains in our health facilities as well as in the communities.