Abstract
BackgroundAntimicrobial resistance has been declared by the World Health Organization as a threat to the public health. The aim of this study was to analyze antimicrobial resistance patterns of the common pathogens occurring at the Bugando Medical Centre (BMC), Mwanza, Tanzania to provide data for antimicrobial stewardship programmes.MethodsA total of 3330 microbiological culture results scripts representing non-repetitive specimens reported between June 2013 and May 2015 were retrieved and analyzed for pathogens and their susceptibility patterns using STATA-11 software.ResultsOut of 3330 specimens, 439 (13.2%) had positive culture. Staphylococcus aureus (n = 100; 22.8%), Klebsiella pneumoniae (n = 65; 14.8%) and Escherichia coli (n = 41; 9.3%) were the most frequently isolated bacteria. Of 78 Staphylococcus aureus tested, 27 (34.6%) were found to be methicillin resistant Staphylococcus aureus (MRSA). Rates of resistance of Klebsiella pneumoniae and Escherichia coli isolates to third generation cephalosporins were 38.5% (25/65) and 29.3% (12/41) respectively. Staphylococcus aureus and Klesbiella pneumoniae were commonly isolated from bloodstream infections while Escherichia coli and Pseudomonas aeruginosa were the predominant isolates from urinary tract and wounds infections respectively. Of 23 Salmonella species isolated, 22 (95%) were recovered from the blood. Nine of the 23 Salmonella species isolates (39%) were found to be resistant to third generation cephalosporins. The resistance rate of gram-negative bacteria to third generation cephalosporins increased from 26.5% in 2014 to 57.9% in 2015 (p = 0.004) while the rate of MRSA decreased from 41.2% in 2013 to 9.5% in 2015 (p = 0.016). Multidrug-resistant gram-negative isolates were commonly isolated from Intensive Care Units and it was noted that, the majority of invasive infections were due to gram-negative bacteria.ConclusionThere is an increase in proportion of gram-negative isolates resistant to third generation cephalosporins. The diversity of potential pathogens resistant to commonly prescribed antibiotics underscores the importance of sustained and standardized antimicrobial resistance surveillance and antibiotic stewardship programmes in developing countries.
Highlights
Antimicrobial resistance has been declared by the World Health Organization as a threat to the public health
The emerging of these multidrug-resistant clones coupled with the introduction of expensive and last resort antibiotics such as carbapenems and vancomycin pose a great challenge in combating Antimicrobial resistance (AMR) at Bugando Medical Centre (BMC) and in developing countries at large
The observed high proportion of gram-negative isolates being resistant to third generation cephalosporins is alarming and calls for a surveillance of healthcareassociated infections (HCAIs) and community infections to establish the source and transmission pathways
Summary
Antimicrobial resistance has been declared by the World Health Organization as a threat to the public health. Infections due to multidrug-resistant isolates have been found to be associated with increased morbidity and mortality [17, 18] The emerging of these multidrug-resistant clones coupled with the introduction of expensive and last resort antibiotics such as carbapenems and vancomycin pose a great challenge in combating AMR at BMC and in developing countries at large. This analysis was done to assess the pattern of bacterial isolates and their susceptibility patterns from various specimens received at BMC microbiological laboratory between June 2013 and May 2015. These data are crucial in rationalizing empirical treatment and set measures for IPC, surveillance and policy change in Tanzania and in other developing countries
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