Antibiotic susceptibility patterns of pathogens isolated from laboratory specimens at Livingstone Central Hospital in Zambia

Abstract

Background Multidrug resistance (MDR) is a global problem that require multifaceted effort to curb it. This study aimed to evaluate the antibiotic susceptibility patterns of routinely isolated bacteria at Livingstone Central Hospital (LCH). Methods A retrospective study was performed on all isolated organisms from patient specimens that were processed from January 2019 to December 2021. Specimens were cultured on standard media and Kirby-Bauer disc diffusion method was employed for susceptibility testing following the Clinical and Laboratory Standard Institute’s recommendations. Results A total of 765 specimens were processed and only 500 (65.4%) met the inclusion criteria. Of the 500, 291(58.2%) specimens were received from female and from the age-group 17–39 years (253, 50.6%) and 40–80 years (145, 29%) in form of blood (331, 66.2%), urine (165, 33%) and sputum (4, 0.8%). Amongst the bacterial isolates, Staphylococcus aureus (142, 28.4%) was the commonest followed by Escherichia coli (91, 18.2%), and Enterobacter agglomerans (76, 15.2%), and Klebsiella pneumoniae (43, 8.6%). The resistance pattern revealed ampicillin (93%) as the least effective drug followed by oxacillin (88%), penicillin (85.6%), co-trimoxazole (81.5%), erythromycin (71.9%), nalidixic acid (68%), and ceftazidime (60%) whereas the most effective antibiotics were imipenem (14.5%), and piperacillin/tazobactam (16.7%). The screening of methicillin resistant Staphylococcus aureus (MRSA) with cefoxitin showed 23.7% (9/38) resistance. Conclusion Increased levels of MDR strains and rising numbers of MRSA strains were detected. Therefore, re-establishing of the empiric therapy is needed for proper patient management, studies to determine the levels of extended spectrum beta lactamase- and carbapenemase-producing bacteria are warranted.

Characterization of Antibiotic Resistance in Select Tertiary Hospitals in Uganda: An Evaluation of 2020 to 2023 Routine Surveillance Data

“…However, few prior research efforts have focused on the effect of specimen type on AMR. Studies by Mwansa et al showed that Staphylococcus aureus resistance to tetracycline was influenced by specimen type, being lower in urine compared to blood [ 32 ]. Likewise, Escherichia coli isolated from sputum had higher resistance to common antibiotics compared to those isolated from blood and urine, except for urine, where Escherichia coli was more resistant to fluoroquinolones than that from sputum [ 33 ].…”

The Importance of Carbapenemase-Producing Enterobacterales in African Countries: Evolution and Current Burden

“…Scarce or no published data regarding CR or CPE were found for some regions, especially for developing countries or countries where access to carbapenems is limited [180,181]. For many countries, reported data on CPE carriage were inconclusive.…”

A Situation Analysis of the Capacity of Laboratories in Zambia to Conduct Surveillance of Antimicrobial Resistance: Strengths, Weaknesses, Opportunities, and Challenges

“…Zambia is a country in the sub-Saharan African (SSA) region with a reportedly high burden of infectious diseases [47][48][49]. Consequently, the presence of drug-resistant pathogens in healthcare facilities has been reported in several studies [50][51][52][53][54][55][56][57][58]. The Antimicrobial Resistance Coordinating Committee (AMRCC) hosted at the Zambia National Public Health Institute (ZNPHI) has been promoting the establishment and strengthening of AMR surveillance across the country [59,60].…”