1921
Volume 92, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Antimicrobial resistance (AMR) is a serious public health threat in both developed and developing countries. Many developing countries, including Rwanda, lack adequate surveillance systems, and therefore, the prevalence of AMR is not well-known. We conducted a prospective observational study to assess the prevalence of AMR among common bacterial isolates from clinical specimens obtained from patients on the medical wards of Kigali University Teaching Hospital (KUTH). We evaluated the antibiotic sensitivity patterns of bacterial pathogens cultured from urine, blood, sputum, and wound swab specimens obtained over a 6-month period (July 1 to December 30, 2013). There were 154 positive cultures from specimens obtained from 141 unique patients over the study period. Urine, blood, wound swab, and sputum cultures comprised 55.2%, 25.3%, 16.2%, and 3.3% of the total specimens evaluated; 31.4% and 58.7% of and isolates, respectively, were resistant to at least one of the third generation cephalosporins. Eight percent of isolates were resistant to imipenem; 82% and 6% of strains were oxacillin- and vancomycin-resistant respectively. Antimicrobial resistance rates are high in Rwanda and pose a serious therapeutic challenge to the management of common infections.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.14-0607
2015-04-01
2017-09-23
Loading full text...

Full text loading...

/deliver/fulltext/14761645/92/4/865.html?itemId=/content/journals/10.4269/ajtmh.14-0607&mimeType=html&fmt=ahah

References

  1. Levy SB, , 2002. The Antibiotic Paradox: How the Misuse of Antibiotics Destroys Their Curative Powers. Cambridge, MA: Perseus Publishing.
  2. Crowder MW, Spencer J, Vila AJ, , 2006. Metallo-beta-lactamases: novel weaponry for antibiotic resistance in bacteria. Acc Chem Res 39: 721728.[Crossref]
  3. Levy SB, , 2001. Antibiotic resistance: consequences of inaction. Clin Infect Dis 33 (Suppl 3): S124S129.[Crossref]
  4. Tzouvelekis LS, Markogiannakis A, Psichogiou M, Tassios PT, Daikos GL, , 2012. Carbapenemases in Klebsiella pneumoniae and other Enterobacteriaceae: an evolving crisis of global dimensions. Clin Microbiol Rev 25: 682707.[Crossref]
  5. Falagas ME, Karageorgopoulos DE, Leptidis J, Korbila IP, , 2013. MRSA in Africa: filling the global map of antimicrobial resistance. PLoS ONE 8: e68024.[Crossref]
  6. Seni J, Najjuka CF, Kateete DP, Makobore P, Joloba ML, Kajumbula H, Kapesa A, Bwanga F, , 2013. Antimicrobial resistance in hospitalized surgical patients: a silently emerging public health concern in Uganda. BMC Res Notes 6: 298.[Crossref]
  7. Muvunyi CM, Masaisa F, Bayingana C, Mutesa L, Musemakweri A, Muhirwa G, Claeys GW, , 2011. Decreased susceptibility to commonly used antimicrobial agents in bacterial pathogens isolated from urinary tract infections in Rwanda: need for new antimicrobial guidelines. Am J Trop Med Hyg 84: 923928.[Crossref]
  8. Lubell Y, Ashley EA, Turner C, Turner P, White NJ, , 2011. Susceptibility of community-acquired pathogens to antibiotics in Africa and Asia in neonates–an alarmingly short review. Trop Med Int Health 16: 145151.[Crossref]
  9. Leopold SJ, van Leth F, Tarekegn H, Schultsz C, , 2014. Antimicrobial drug resistance among clinically relevant bacterial isolates in sub-Saharan Africa: a systematic review. J Antimicrob Chemother 69: 23372353.[Crossref]
  10. Bell JM, Turnidge JD, Jones RN, , 2002. Antimicrobial resistance trends in community-acquired respiratory tract pathogens in the Western Pacific Region and South Africa: report from the SENTRY antimicrobial surveillance program, (1998–1999) including an in vitro evaluation of BMS284756. Int J Antimicrob Agents 19: 125132.[Crossref]
  11. Blomberg B, Mwakagile DS, Urassa WK, Maselle SY, Mashurano M, Digranes A, Harthug S, Langeland N, , 2004. Surveillance of antimicrobial resistance at a tertiary hospital in Tanzania. BMC Public Health 4: 45.[Crossref]
  12. Kesah C, Ben Redjeb S, Odugbemi TO, Boye CS, Dosso M, Ndinya Achola JO, Koulla-Shiro S, Benbachir M, Rahal K, Borg M, , 2003. Prevalence of methicillin-resistant Staphylococcus aureus in eight African hospitals and Malta. Clin Microbiol Infect 9: 153156.[Crossref]
  13. Brink A, Feldman C, Richards G, Moolman J, Senekal M, , 2008. Emergence of extensive drug resistance (XDR) among Gram-negative bacilli in South Africa looms nearer. S Afr Med J 98: 586590.
  14. Bertrand X, Dowzicky MJ, , 2012. Antimicrobial susceptibility among gram-negative isolates collected from intensive care units in North America, Europe, the Asia-Pacific Rim, Latin America, the Middle East, and Africa between 2004 and 2009 as part of the Tigecycline Evaluation and Surveillance Trial. Clin Ther 34: 124137.[Crossref]
  15. Khanfar HS, Bindayna KM, Senok AC, Botta GA, , 2009. Extended spectrum beta-lactamases (ESBL) in Escherichia coli and Klebsiella pneumoniae: trends in the hospital and community settings. J Infect Dev Ctries 3: 295299.
  16. Ghafourian S, Sadeghifard N, Soheili S, Sekawi Z, , 2014. Extended spectrum beta-lactamases: definition, classification and epidemiology. Curr Issues Mol Biol 17: 1122.
  17. Dibua UM, Onyemerela IS, Nweze EI, , 2014. Frequency, urinalysis and susceptibility profile of pathogens causing urinary tract infections in Enugu State, southeast Nigeria. Rev Inst Med Trop Sao Paulo 56: 5559.[Crossref]
  18. Assefa A, Asrat D, Woldeamanuel Y, G/Hiwot Y, Abdella A, Melesse T, , 2008. Bacterial profile and drug susceptibility pattern of urinary tract infection in pregnant women at Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia. Ethiop Med J 46: 227235.
  19. Masinde A, Gumodoka B, Kilonzo A, Mshana SE, , 2009. Prevalence of urinary tract infection among pregnant women at Bugando Medical Centre, Mwanza, Tanzania. Tanzan J Health Res 11: 154159.[Crossref]
  20. Kariuki S, Revathi G, Corkill J, Kiiru J, Mwituria J, Mirza N, Hart CA, , 2007. Escherichia coli from community-acquired urinary tract infections resistant to fluoroquinolones and extended-spectrum beta-lactams. J Infect Dev Ctries 1: 257262.
  21. Obeng-Nkrumah N, Twum-Danso K, Krogfelt KA, Newman MJ, , 2013. High levels of extended-spectrum beta-lactamases in a major teaching hospital in Ghana: the need for regular monitoring and evaluation of antibiotic resistance. Am J Trop Med Hyg 89: 960964.[Crossref]
  22. Kang CI, Wi YM, Lee MY, Ko KS, Chung DR, Peck KR, Lee NY, Song JH, , 2012. Epidemiology and risk factors of community onset infections caused by extended-spectrum beta-lactamase-producing Escherichia coli strains. J Clin Microbiol 50: 312317.[Crossref]
  23. Anonymous, 2012. Rwanda 2010: results from the demographic and health survey. Stud Fam Plann 43: 153158.[Crossref]
  24. Gangoue-Pieboji J, Koulla-Shiro S, Ngassam P, Adiogo D, Ndumbe P, , 2006. Antimicrobial activity against gram negative bacilli from Yaounde Central Hospital, Cameroon. Afr Health Sci 6: 232235.
  25. Ibrahim ME, Bilal NE, Hamid ME, , 2012. Increased multi-drug resistant Escherichia coli from hospitals in Khartoum state, Sudan. Afr Health Sci 12: 368375.
  26. Brink AJ, Coetzee J, Clay CG, Sithole S, Richards GA, Poirel L, Nordmann P, , 2012. Emergence of New Delhi metallo-beta-lactamase (NDM-1) and Klebsiella pneumoniae carbapenemase (KPC-2) in South Africa. J Clin Microbiol 50: 525527.[Crossref]
  27. Livermore DM, Winstanley TG, Shannon KP, , 2001. Interpretative reading: recognizing the unusual and inferring resistance mechanisms from resistance phenotypes. J Antimicrob Chemother 48 (Suppl 1): 87102.[Crossref]
  28. Maina EK, Kiiyukia C, Wamae CN, Waiyaki PG, Kariuki S, , 2013. Characterization of methicillin-resistant Staphylococcus aureus from skin and soft tissue infections in patients in Nairobi, Kenya. Int J Infect Dis 17: e115e119.[Crossref]
  29. Kolawole DO, Adeyanju A, Schaumburg F, Akinyoola AL, Lawal OO, Amusa YB, Kock R, Becker K, , 2013. Characterization of colonizing Staphylococcus aureus isolated from surgical wards' patients in a Nigerian university hospital. PLoS ONE 8: e68721.[Crossref]
  30. Rebiahi SA, Abdelouahid DE, Rahmoun M, Abdelali S, Azzaoui H, , 2011. Emergence of vancomycin-resistant Staphylococcus aureus identified in the Tlemcen university hospital (North-West Algeria). Med Mal Infect 41: 646651.[Crossref]
  31. Ferraz V, Duse AG, Kassel M, Black AD, Ito T, Hiramatsu K, , 2000. Vancomycin-resistant Staphylococcus aureus occurs in South Africa. S Afr Med J 90: 1113.
  32. Tofteland S, Haldorsen B, Dahl KH, Simonsen GS, Steinbakk M, Walsh TR, Sundsfjord A, Norwegian ESBL Study Group; , 2007. Effects of phenotype and genotype on methods for detection of extended-spectrum-β-lactamase-producing clinical isolates of Escherichia coli and Klebsiella pneumoniae in Norway. J Clin Microbiol 45: 199205.[Crossref]
  33. Platteel TN, Cohen Stuart JW, de Neeling AJ, Voets GM, Scharringa J, van de Sande N, Fluit AC, Bonten MJ, Leverstein-van Hall MA, , 2013. Multi-centre evaluation of a phenotypic extended spectrum beta-lactamase detection guideline in the routine setting. Clin Microbiol Infect 19: 7076.[Crossref]
  34. Boutiba-Ben Boubaker I, Ben Abbes R, Ben Abdallah H, Mamlouk K, Mahjoubi F, Kammoun A, Hammami A, Ben Redjeb S, , 2004. Evaluation of a cefoxitin disk diffusion test for the routine detection of methicillin-resistant Staphylococcus aureus . Clin Microbiol Infect 10: 762765.[Crossref]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.14-0607
Loading
/content/journals/10.4269/ajtmh.14-0607
Loading

Data & Media loading...

  • Received : 26 Sep 2014
  • Accepted : 17 Dec 2014

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error