Few hours after a peace deal was signed in Rome, violence erupted between armed groups in Central African Republic.

13 of the 14 armed groups signed the agreement Monday that called for an immediate cease-fire. However, Doctors Without Borders said fighting resumed early Tuesday in the beleaguered town of Bria.

"At 9:30 a.m. we already received 35 wounded at the hospital, mostly gunshot wounds," said Mumuza Muhindo Musubaho, project coordinator in Bria for the international aid group also known by its French acronym MSF.

Gunfire also was reported Tuesday in the towns of Bangassou and Alindao, according to MSF, which said the security situation "remains extremely volatile."

The peace deal was brokered by the Sant'Egidio Catholic Community, though there was widespread skepticism in Central African Republic given similar failed efforts in the past.

Ten armed groups and the country's Defense Ministry signed a peace deal in 2015. Another accord, shepherded by the African Union, was signed in 2014. Neither lasted.