{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T23:56:40Z","timestamp":1769126200085,"version":"3.49.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antimicrobial resistance (AMR) is a growing global threat with disproportionate impact in resource-limited settings. We characterized clinically significant bacteria in Goma, Democratic Republic of the Congo (DRC), and their susceptibility using the WHO AWaRe framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional study (September 2019\u2013March 2022) of routine clinical specimens (blood cultures, urine, vaginal, perineal swabs and pus). Specimens were cultured on standard nonselective (chocolate agar with polyvitamin supplement, fresh blood agar, tryptican broth) and selective media (MacConkey and Chapman agar); isolates were identified locally and referred to the Laboratoire Hospitalier Universitaire de Bruxelles (LHUB-ULB) for confirmation and antimicrobial susceptibility testing (AST).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 341 isolates underwent AST.\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      was most prevalent (~27%), followed by\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      and\n                      <jats:italic>Enterococcus faecalis<\/jats:italic>\n                      . Enterobacterales exhibited high non-susceptibility to first- and second-line AWaRe Access agents. In\n                      <jats:italic>E. coli<\/jats:italic>\n                      , resistance exceeded 60% to ampicillin, amoxicillin\/clavulanate, and ciprofloxacin.\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      showed uniform resistance to ampicillin and high resistance to cefuroxime, cefotaxime, gentamicin, and colistin. These patterns constrain the effectiveness of commonly used empiric regimens.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AMR is a major public-health problem in Goma. Strengthening laboratory capacity and establishing continuous surveillance are urgent priorities. Recommended actions include participation in WHONET\/GLASS program and antibiotic stewardship. In the interim, empiric strategies should favor nitrofurantoin for uncomplicated cystitis, judicious aminoglycoside use where appropriate, early culture, and prompt de-escalation, reserving carbapenems for severe ESBL-risk presentations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1696339","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T06:56:28Z","timestamp":1769064988000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Antimicrobial resistance of bacteria isolated in a resource-limited region: the experience of the North Kivu Provincial Reference Laboratory in the Democratic Republic of the Congo"],"prefix":"10.3389","volume":"13","author":[{"given":"Emmanuel","family":"Busha Tibasima","sequence":"first","affiliation":[{"name":"Department of Pediatrics and Child Health, Universit\u00e9 Libre des Pays des Grands Lacs","place":["Goma, Democratic Republic of Congo"]},{"name":"Universit\u00e9 Libre de Bruxelles","place":["Brussels, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prudence Mitangala","family":"Ndeba","sequence":"additional","affiliation":[{"name":"Departement of Epidemiology, Universit\u00e9 de Ruwenzori","place":["Butembo, Democratic Republic of Congo"]},{"name":"ULB\u2013Coop\u00e9ration","place":["Goma, Democratic Republic of Congo"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Banga","family":"Mseza","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Faculty of Clinical Medicine and Dentistry, Kampala International University","place":["Ishaka, Uganda"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ousmane","family":"Sy","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Libre de Bruxelles","place":["Brussels, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stella d\u2019Esp\u00e9rance Assumini","family":"Ndeba","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Universit\u00e9 Libre des Pays des Grands Lacs","place":["Goma, Democratic Republic of Congo"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Houssein","family":"Chalhoub","sequence":"additional","affiliation":[{"name":"Research and Technology Innovation Unit, Laboratoire Hospitalier Universitaire de Bruxelles-Universitair Laboratorium Brussel (LHUB-ULB), Universit\u00e9 Libre de Bruxelles (ULB)","place":["Brussels, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphael","family":"Senga","sequence":"additional","affiliation":[{"name":"Ami-Labo","place":["Goma, Democratic Republic of Congo"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kasereka","family":"Kihemba","sequence":"additional","affiliation":[{"name":"Laboratory Department, Basic Sciences and Pathological Anatomy, Heal Africa Hospital, Goma, Democratic Republic of Congo","place":["Goma, Democratic Republic of Congo"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baudouin","family":"Byl","sequence":"additional","affiliation":[{"name":"Clinique d\u2019\u00c9pid\u00e9miologie et Hygi\u00e8ne Hospitali\u00e8re, H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles (ULB)","place":["Brussels, Belgium"]},{"name":"Facult\u00e9 de M\u00e9decine Pharmacie Sciences Biom\u00e9dicales, Universit\u00e9 de Mons","place":["Mons, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Vandenberg","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Libre de Bruxelles","place":["Brussels, Belgium"]},{"name":"ULB\u2013Coop\u00e9ration","place":["Goma, Democratic Republic of Congo"]},{"name":"Center for Environmental and Occupational Health, School of Public Health, Universit\u00e9 Libre de Bruxelles (ULB)","place":["Brussels, 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