Antimicrobial Resistance profiles of staphylococcus aureus in farming communities of Isingiro and Kamuli districts, Uganda

Abstract

Background: Bacterial resistance to antibiotics is fast becoming a big challenge as resistance to multiple drugs is rising rapidly. The emergence of resistant Staphylococcus aureus worldwide is life-threatening in both humans and animals and yet little is known about the burden of antimicrobial resistance (AMR) in developing countries including Uganda. Therefore, the aims of this study were to: (a) determine the prevalence of AMR in S. aureus among humans and animals in two districts of Uganda; (b) assess the knowledge, attitude, and practices (KAPs) of farmers in Uganda regarding AMR of S. aureus. Methods: This was a cross-sectional study conducted between July and September 2020 in 147 randomly selected cattle keeping households in Isingiro and Kamuli districts. A structured questionnaire uploaded in Kobocollect online data collection tool was used to assess farmers’ perceptions and practices pertaining to AMR in each of the selected households. Nasal swab samples were collected from both animals and humans (farmers), placed in Stuart Transport medium and taken to the laboratory for processing. Bacterial isolation and confirmation was done using gram-staining and biochemical tests. This was followed by Antimicrobial susceptibility testing (AST) by the Kirby Bauer disc diffusion method. A cleaned Ms excel data file from Kobocollect tool was imported into STATA version 14 to generate descriptive statistics of the AMR patterns, farmers’ perceptions of AMR as well as the practices associated with AMR occurrence in the two districts. Results: Only 14/147 (9.5%) cattle samples and 45/147(30.6%) human samples tested positive for S. aureus and, were assessed for AMR. All (100%) cattle S. aureus isolates were resistant to Nitroimidazoles while 92.9% were resistant to Penicillins. None of the isolates were resistant to Fluoroquinolones (0.0%) and Aminoglycosides (0.0%). All the 14 isolates exhibited antimicrobial resistance (AMR) to at least one of the assessed antibiotics and 92.9% (13/14) showed evidence of multidrug resistance (MDR). Likewise, S. aureus human isolates showed high levels of resistance to Nitroimidazoles (100%) and Penicillins (93.3%), with none of the isolates having resistance to Aminoglycosides (0.0%), and only 1 exhibiting resistance to Fluoroquinolones (2.2%). All the 45 human isolates exhibited AMR to at least a one antibiotic while 93% (42/45) had MDR. Most farmers had good perceptions about AMR, with a significantly higher proportion of respondents from Isingiro showing a better understanding of AMR than those from Kamuli. Conclusion: This study provides evidence of occurrence of AMR to antibiotics commonly used in both humans and livestock in Isingiro and Kamuli districts. There is a need to promote appropriate stewardship of antibiotics to minimize the risk of AMR.