[Antibiotic sensitivity to epidemic strains of Vibrio cholerae and Shigella dysenteriae 1 isolated in Rwandan refugee camps in Zaire]

Multiresistance or epidemic enteric bacteria to antibiotics greatly complicates treatment, and in some cases prophylaxis, of severe invasive gastroenteritis. During the summer of 1994, two epidemics of diarrhea, one due to Vibrio cholerae and the other to Shigella dysenteriae 1 isolated from the Goma and Bukavu camps was determined by measurement of the Agar Minimal Inhibitory Concentration. Multiresistance to tetracyclins, aminopenicillins, trimethoprimsulfamethoxazole, and nifuroxazide was observed. After intensive treatment mutant forms of both bacteria resistant to nalidixic acid rapidly appeared. Only fluoroquinolones remained active on these mutant strains, but the availability of this agent in Africa is restricted due to cost. The most effective way of preventing resistance is to limit the spread of enteric infections by health education and improvement of hygiene. This can be difficult during wartime.