Secka F et al.2019. Bacteremia in childhood life-threatening infections in urban Gambia: EUCLIDS in West Africa. Open Forum Infect Dis 6: ofz332.
Minarini L , de Andrade LN , De Gregorio E , Grosso F , Naas T , Zarrilli R , Camargo I , 2020. Editorial: antimicrobial resistance as a global public health problem: how can we address it? Front Public Health 8: 612844.
Laxminarayan R et al.2013. Antibiotic resistance: the need for global solutions. Lancet Infect Dis 13: 1057–1098.
Zheng YZ , Li J , Le SH , Zheng H , Hua XL , Chen ZS , Zheng L , Chen C , Hu JD , 2019. Bacterial distribution and drug resistance of pathogens of blood stream infection in children with hematological malignancies after chemotherapy. Zhonghua Xue Ye Xue Za Zhi 40: 235–237.
Azimi T , Maham S , Fallah F , Azimi L , Gholinejad Z , 2019. Evaluating the antimicrobial resistance patterns among major bacterial pathogens isolated from clinical specimens taken from patients in Mofid Children’s Hospital, Tehran, Iran: 2013–2018. Infect Drug Resist 12: 2089–2102.
Capozzi C , Maurici M , Pana A , 2019. Antimicrobial resistance: it is a global crisis, “a slow tsunami”. Ig Sanita Pubbl 75: 429–450.
Habyarimana T , Murenzi D , Musoni E , Yadufashije C , F NN , 2021. Bacteriological profile and antimicrobial susceptibility patterns of bloodstream infection at Kigali University Teaching Hospital. Infect Drug Resist 14: 699–707.
Davies J , Davies D , 2010. Origins and evolution of antibiotic resistance. Microbiol Mol Biol Rev 74: 417–433.
Martinez JL , 2014. General principles of antibiotic resistance in bacteria. Drug Discov Today Technol 11: 33–39.
Munita JM , Arias CA , 2016. Mechanisms of antibiotic resistance. Microbiol Spectr 4: PMC4888801.
Kruis T , Guse-Jaschuck S , Siegmund B , Adam T , Epple HJ , 2020. Use of microbiological and patient data for choice of empirical antibiotic therapy in acute cholangitis. BMC Gastroenterol 20: 65.
Yodoshi T , Matsushima M , Taniguchi T , Kinjo S , 2019. Utility of point-of-care Gram stain by physicians for urinary tract infection in children ≤ 36 months. Medicine (Baltimore) 98: e15101.
Williams PCM , Isaacs D , Berkley JA , 2018. Antimicrobial resistance among children in sub-Saharan Africa. Lancet Infect Dis 18: e33–e44.
Thomson KM et al.2021. Effects of antibiotic resistance, drug target attainment, bacterial pathogenicity and virulence, and antibiotic access and affordability on outcomes in neonatal sepsis: an international microbiology and drug evaluation prospective substudy (BARNARDS). Lancet Infect Dis 21: 1677–1688.
Bonniface M , Nambatya W , Rajab K , 2021. An evaluation of antibiotic prescribing practices in a rural refugee settlement district in Uganda. Antibiotics (Basel) 10: PMC7915286.
Al-Hasan MN , Gould AP , Drennan C , Hill O , Justo JA , Kohn J , Brandon Bookstaver P , 2019. Empirical fluoroquinolones versus broad-spectrum beta-lactams for Gram-Negative bloodstream infections in the absence of antimicrobial resistance risk factors. J Glob Antimicrob Resist.
Bryce A , Hay AD , Lane IF , Thornton HV , Wootton M , Costelloe C , 2016. Global prevalence of antibiotic resistance in paediatric urinary tract infections caused by Escherichia coli and association with routine use of antibiotics in primary care: systematic review and meta-analysis. BMJ 352: i939.
Miyazaki M , Yamada Y , Matsuo K , Komiya Y , Uchiyama M , Nagata N , Takata T , Jimi S , Imakyure O , 2019. Change in the antimicrobial resistance profile of extended-spectrum beta-lactamase-producing Escherichia coli. J Clin Med Res 11: 635–641.
Gupta M , Naik AK , Singh SK , 2019. Bacteriological profile and antimicrobial resistance patterns of burn wound infections in a tertiary care hospital. Heliyon 5: e02956.
Ntirenganya C , Manzi O , Muvunyi CM , Ogbuagu O , 2015. High prevalence of antimicrobial resistance among common bacterial isolates in a tertiary healthcare facility in Rwanda. Am J Trop Med Hyg 92: 865–870.
Iwanaga N , Sandquist I , Wanek A , McCombs JE , Song K , Kolls J , 2020. Host immunology and rational immunotherapy for carbapenem-resistant Klebsiella pneumoniae infection. JCI Insight.
Simoes ESAC , Oliveira EA , Mak RH , 2020. Urinary tract infection in pediatrics: an overview. J Pediatr (Rio J) 96 (Suppl 1): 65–79.
San T , Aung MS , San N , Aung MMZ , Mon WLY , Thazin TE , Kobayashi N , 2022. Bacterial species and antimicrobial resistance of clinical isolates from pediatric patients in Yangon, Myanmar, 2020. Infect Dis Rep 14: 26–32.
Kayastha K , Dhungel B , Karki S , Adhikari B , Banjara MR , Rijal KR , Ghimire P , 2020. Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella species in pediatric patients visiting International Friendship Children’s Hospital, Kathmandu, Nepal. Infect Dis (Auckl) 13: 1178633720909798.
Seni J , Mwakyoma AA , Mashuda F , Marando R , Ahmed M , DeVinney R , Pitout JDD , Mshana SE , 2019. Deciphering risk factors for blood stream infections, bacteria species and antimicrobial resistance profiles among children under five years of age in north-western Tanzania: a multicentre study in a cascade of referral health care system. BMC Pediatr 19: 32.
Hendriksen RS , Vieira AR , Karlsmose S , Lo Fo Wong DM , Jensen AB , Wegener HC , Aarestrup FM , 2011. Global monitoring of Salmonella serovar distribution from the World Health Organization Global Foodborne Infections Network Country Data Bank: results of quality assured laboratories from 2001 to 2007. Foodborne Pathog Dis 8: 887–900.
Tian L , Sun Z , Zhang Z , 2018. Antimicrobial resistance of pathogens causing nosocomial bloodstream infection in Hubei Province, China, from 2014 to 2016: a multicenter retrospective study. BMC Public Health 18: 1121.
Luo K , Tang J , Qu Y , Yang X , Zhang L , Chen Z , Kuang L , Su M , Mu D , 2021. Nosocomial infection by Klebsiella pneumoniae among neonates: a molecular epidemiological study. J Hosp Infect 108: 174–180.
Ding Y , Wang Y , Hsia Y , Sharland M , Heath PT , 2019. Systematic review of carbapenem-resistant Enterobacteriaceae causing neonatal sepsis in China. Ann Clin Microbiol Antimicrob 18: 36.
Yang Y , Liu J , Muhammad M , Liu H , Min Z , Lu J , Zhang L , Chai Z , 2021. Factors behind the prevalence of carbapenem-resistant Klebsiella pneumoniae in pediatric wards. Medicine (Baltimore) 100: e27186.
Raeispour M , Ranjbar R , 2018. Antibiotic resistance, virulence factors and genotyping of uropathogenic Escherichia coli strains. Antimicrob Resist Infect Control 7: 118.
Agyeman AA , Bergen PJ , Rao GG , Nation RL , Landersdorfer CB , 2020. A systematic review and meta-analysis of treatment outcomes following antibiotic therapy among patients with carbapenem-resistant Klebsiella pneumoniae infections. Int J Antimicrob Agents 55: 105833.
Almohammady MN , Eltahlawy EM , Reda NM , 2020. Pattern of bacterial profile and antibiotic susceptibility among neonatal sepsis cases at Cairo University Children Hospital. J Taibah Univ Med Sci 15: 39–47.
Catchup Study Group , 2002. Clinical efficacy of co-trimoxazole versus amoxicillin twice daily for treatment of pneumonia: a randomised controlled clinical trial in Pakistan. Arch Dis Child 86: 113–118.
Sutherland T et al.2019. Widespread antimicrobial resistance among bacterial infections in a Rwandan referral hospital. PLoS One 14: e0221121.
Malik B , Bhattacharyya S , 2019. Antibiotic drug-resistance as a complex system driven by socio-economic growth and antibiotic misuse. Sci Rep 9: 9788.
Salem ML , Ghaber SM , Baba SE , Maouloud MM , 2016. Antibiotic susceptibility of community-acquired strains of Staphylococcus aureus in Nouakchott region (Mauritania). Pan Afr Med J 24: 276.
Zhanel GG , Simor AE , Vercaigne L , Mandell L , Canadian Carbapenem Discussion Group , 1998. Imipenem and meropenem: comparison of in vitro activity, pharmacokinetics, clinical trials and adverse effects. Can J Infect Dis 9: 215–228.
McGuinness WA , Malachowa N , DeLeo FR , 2017. Vancomycin resistance in Staphylococcus aureus. Yale J Biol Med 90: 269–281.
Canty E , Carnahan B , Curley T , Anususinha E , Hamdy RF , Ericson JE , 2021. Reduced vancomycin susceptibility, MRSA and treatment failure in pediatric Staphylococcus aureus bloodstream infections. Pediatr Infect Dis J 40: 429–433.
|Past two years||Past Year||Past 30 Days|
|Full Text Views||56||56||10|
Bacterial infections pose a global threat, especially in the pediatric population. Antimicrobials that are used to treat such infections continuously show reduced efficacy, and empirical therapy is a major treatment option in Rwanda. This study aimed to determine the resistance rate of commonly used antibiotics in pediatric patients. The study was conducted from June 1, 2018 to May 30, 2019, and microbiological samples were collected from 712 children with suspected bacterial infections. Antimicrobial sensitivity testing was performed on 177 positive cultures (24%) that were considered for data analysis. The findings show that the major bacterial isolates were Klebsiella pneumoniae (n = 50, 28.2%), Escherichia coli (n = 47, 26.5%), and Staphylococcus aureus (n = 38, 21.4%). In general, the greatest antibiotic resistance rate was observed in ampicillin (n = 125, 86.2%), amoxicillin–clavulanic acid (n = 84, 82.4%), amoxicillin (n = 64, 79%), cefadroxil (n = 83, 69.2%), tetracycline (n = 72, 59.7%), ceftazidime (n = 42, 55.3%), and cefuroxime (n = 14, 53.8%). More specifically, Klebsiella pneumoniae was 100% resistant to amoxicillin-clavulanic acid, cefuroxime, trimethoprim–sulfamethoxazole, ceftazidime, erythromycin, and clindamycin. Staphylococcus aureus was 86.7% resistant to ampicillin, and Escherichia coli was 91.7% resistant to tetracycline, 90.6% resistant to ampicillin, 83.3% resistant to amoxicillin–clavulanic acid, 79.3% resistant to cefadroxil, and 78.6% resistant to ceftazidime. Moreover, Klebsiella pneumoniae from blood and urine was 96.8% and 100% sensitive, respectively, to meropenem. Staphylococcus aureus from blood was 100% sensitive to vancomycin, whereas Escherichia coli from urine was sensitive to clindamycin (100%), nitrofurantoin (80.6%), and ciprofloxacin (72.7%). In conclusion, our findings show a high resistance rate to commonly used antibiotics, which suggests precaution in empirical therapy and continued surveillance of antimicrobial resistance.
Authors’ addresses: Jean Bosco Munyemana and Emile Musoni, Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda, and Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda, E-mails: firstname.lastname@example.org and email@example.com. Bright Gatare, Department of Biomedical Laboratory Sciences, Faculty of Allied Fundamental Sciences, INES-Ruhengeri, Ruhengeri, Rwanda, E-mail: firstname.lastname@example.org, Pauline Kabanyana, Department of Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda, E-mail: email@example.com. Andrew Ivang, Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda, E-mail: firstname.lastname@example.org. Djibril Mbarushimana and Innocent Itangishaka, Department of Pathology, University Teaching Hospital of Butare, Butare, Rwanda, E-mails: email@example.com and firstname.lastname@example.org. Jean Damascene Niringiyumukiza, Department of Gynecology and Obstetrics, University Teaching Hospital of Butare, Butare, Rwanda, E-mail: email@example.com.