Antimicrobial Resistance Profiles for Different Isolates in Aden, Yemen: A Cross-Sectional Study in a Resource-Poor Setting

Badulla, Wafa F. S.; Alshakka, Mohammed; Ibrahim, Mohamed Izham Mohamed

doi:10.1155/2020/1810290

Cited by 18 publications

(20 citation statements)

References 43 publications

(43 reference statements)

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“…In a recent study of AMR in Aden, Yemen, by Badulla et al (2020), the resistance to amoxicillin/clavulanic acid among seven bacterial species isolated from various clinical specimens – urine, pus and wound – was an average of 65.2%. 24 This study raises questions about the continued efficacy of amoxicillin and amoxicillin/clavulanic acid in Yemen.…”

Section: Discussionmentioning

confidence: 99%

“…The high level of AMR in Yemen perceived by participants indicates awareness among physicians and pharmacists, considered frontline health workers, in this survey and is corroborated by the earlier mentioned studies reporting laboratory investigations. 24–30…”

Section: Discussionmentioning

confidence: 99%

“…1 In Yemen, ciprofloxacin is the first choice antibiotic treatment for several infections including UTIs and gastrointestinal infections including typhoid. 24 Both of these antibiotics were for oral use, with amoxicillin a preferred choice in susceptible RTIs, especially in children, as contained in the national EML and guidelines for child health programs in Yemen which is widely supported by international organizations.…”

Section: Discussionmentioning

confidence: 99%

“…Ethical clearance (REC-81-2020) was obtained from the Research Ethics Committee of the University of Aden – in line with similar studies – before questionnaires were distributed. 24…”

Section: Methodsmentioning

confidence: 99%

“…22,23 Several studies already suggest a high AMR burden. 24–30 In 2018, for example, among patients admitted to the Médecins Sans Frontiers (MSF) hospital in Aden, more than 60% had a drug resistant infection. 31 These conditions coincide with the current COVID-19 pandemic to further exacerbate the problem.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Assessing antimicrobial resistance, utilization and stewardship in Yemen: An exploratory mixed-methods study

Orubu

Najwa²,

Ching

et al. 2021

Preprint

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Antimicrobial resistance (AMR), largely driven by irrational use of antimicrobials, is a global, multi-faceted problem calling for a complete understanding of all contributory factors for effective containment. In conflict settings, war-wounds and malnutrition can combine with existing social determinants to increase demand for antibiotics, compounding irrational use. In this study, we focus on Yemen, a low-income country with active conflict for the last five years, and analyze the current status of awareness and stewardship efforts regarding AMR. We performed a survey of prescribers/physicians and pharmacists to describe perceptions of AMR prevalence, antibiotic use practices and stewardship in Yemen, supported by a non-systematic scoping literature review and a key informant interview. Participants (96%, n=57) reported a perceived high AMR prevalence rate. Prescribers (74%, 20/27) reported pressure to prescribe broad-spectrum antibiotics. In the majority of cases (81%, 22/27), Antimicrobial Sensitivity Tests (AST) were not performed to inform antibiotic choice. The main barrier to AST was cost. Most pharmacists (67%, 18/27) sold antibiotics without prescriptions. Amoxicillin (including amoxicillin-clavulanate) was the most-commonly prescribed (63%, 17/27) or dispensed (82%, 22/27) antibiotic. AST was rated the least important solution to AMR in Yemen. While there was awareness of a high AMR rate, stewardship is poor in Yemen. We note that barriers to the use of AST could be addressed through the deployment of low-cost AST kits. Compulsory continuing education emphasizing the use of AST to guide prescribing and patients’ awareness programs could help avoid irrational use.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Ethical clearance (REC-81-2020) was obtained from the Research Ethics Committee of the University of Aden – in line with similar studies – before questionnaires were distributed. 24…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessing antimicrobial resistance, utilization and stewardship in Yemen: An exploratory mixed-methods study

Orubu

Najwa²,

Ching

et al. 2021

Preprint

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Analyzing Yemen’s health system at the governorate level amid the ongoing conflict: a case of Al Hodeida governorate

Al Waziza,

Sheikh,

Ahmed

et al. 2023

Discov Health Systems

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Background Yemen is regarded as one of the Middle East’s poorest countries. Decades of political, economic, and social difficulties have culminated in the current protracted conflict. As a result, the globe experienced its worst humanitarian catastrophe. The ongoing war has affected several public services, notably the health sector, which is operating at less than half its capacity. This study aims to examine Yemen’s health system at the governorate level (Al Hodeida) amidst the current conflict. It analyzes current challenges and produces suggestions for enhancement. Methods The study used qualitative research methods such as Key Informant Interviews (KIIs) and document analysis. The study used WHO’s health systems framework to measure health system performance. Twelve KIIs were conducted via Skype with several health stakeholders. In addition, documents were analyzed to inform the subject guide, generate themes, and aid in the triangulation of results. Results According to the study findings, the governorate health system managed to offer a minimum level of healthcare services while making some advances in outbreak control jointly with other partners. One of the main difficulties confronting the governorate’s health system is a severe lack of financial resources forcing it to rely entirely on external aid. Furthermore, other significant deficiencies include inadequate health system organogram, low reporting capacities, insufficient funding, and scarcity of health professionals. Conclusion Yemen’s frail health system has been weakened by almost eight years of insecurity and conflict. If the current scenario continues, most of Yemen’s health system’s operations and indicators will likely deteriorate. On the other hand, progress in some areas, such as primary healthcare (PHC) services and disease management, is remarkable. However, for better performance, Yemen’s health system leadership and stakeholders should seek a holistic strategy to improve the entire dimensions of the health system.

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Antibiotic susceptibility patterns at the Médecins Sans Frontières (MSF) Acute Trauma Hospital in Aden, Yemen: a retrospective study from January 2018 to June 2021

Almehdar,

Yousef,

van den Boogaard

et al. 2024

JAC-Antimicrobial Resistance

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Background Antimicrobial resistance (AMR) is an urgent global health concern, especially in countries facing instability or conflicts, with compromised healthcare systems. Médecins Sans Frontières (MSF) established an acute trauma hospital in Aden, Yemen, treating mainly war-wounded civilians, and implemented an antimicrobial stewardship (AMS) programme. This study aimed to describe clinical characteristics and identify antibiotic susceptibility patterns representative of patients treated with antibiotics. Methods Retrospective cross-sectional study using routinely collected data from all patients treated with antibiotics in the MSF-Aden Acute Trauma hospital between January 2018 and June 2021. Routine clinical data from patients’ files was entered into an AMS electronic database and microbiological data were entered into WHONET. Both databases were imported and merged in REDCap and analysed using RStudio. Results Three hundred and sixty-three of 481 (75%) included patients were injured by violence-related trauma. Most were men aged 19–45 years (n = 331; 68.8%). In total, 598 infections were diagnosed and treated. MDR organisms were identified in 362 (60.5%) infections in 311 (65%) patients. Skin and soft-tissue infections (SSTIs) (n = 143; 24%) were the most common, followed by osteomyelitis (n = 125; 21%) and intra-abdominal-infections (IAIs) (n = 116; 19%), and 111 (19%) secondary bloodstream infections were identified. Escherichia coli was the most frequently identified pathogen, causing IAI (n = 87; 28%) and SSTI (n = 43; 16%), while Staphylococcus aureus caused mainly osteomyelitis (n = 84; 19%). Most Gram-negatives were ESBL producers, including E. coli (n = 193; 81.4%), Klebsiella pneumoniae (n = 72; 77.4%) and Enterobacter cloacae (n = 39; 50%) while most S. aureus were methicillin resistant (n = 93; 72.6%). Conclusions High rates of MDR were found. This information will facilitate a comprehensive review of the empirical antibiotic treatment guidelines.

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Antimicrobial Resistance Profiles for Different Isolates in Aden, Yemen: A Cross-Sectional Study in a Resource-Poor Setting

Cited by 18 publications

References 43 publications

Assessing antimicrobial resistance, utilization and stewardship in Yemen: An exploratory mixed-methods study

Assessing antimicrobial resistance, utilization and stewardship in Yemen: An exploratory mixed-methods study

Analyzing Yemen’s health system at the governorate level amid the ongoing conflict: a case of Al Hodeida governorate

Antibiotic susceptibility patterns at the Médecins Sans Frontières (MSF) Acute Trauma Hospital in Aden, Yemen: a retrospective study from January 2018 to June 2021

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