Surveillance of Antimicrobial resistance among organism causing Bacteremia in patients admitted in Mbarara Regional Referral Hospital, Mbarara, Southwestern Uganda

Abstract

Blood stream infections are the major cause of fevers of undetermined origin in Africa. The continuing emergence of pathogenic microorganisms that are resistant to first-line antimicrobials is a cause of increasing Anti-Microbial Resistance concern. This study aimed at understanding the surveillance of antimicrobial resistance in order to serve as a quality assurance tool to determine common pathogens causing bacteremia, trends of antimicrobial resistance which will guide drug-policy decisions and facilitate rational use of drugs to prevent the further emergence of antimicrobial resistance. This study analyzed results of blood cultures that were routinely taken from patients of different age groups with fever or suspicion of sepsis among patients admitted in different wards of Mbarara Regional Referral Hospital and transported to Mbarara University of Science and Technology, the microbiology laboratory between 2015 and 2022. Bacterial isolates of clinical significance from specimens received during the study period were recorded in WHONET (surveillance software) and exported to STATA for analysis. Bloodstream infections were confirmed in 259 cases over the seven-year study period. Gram positive pathogens accounted for 160 (61.7%) in the confirmed infections while gram negative pathogens accounted for 99 (38.2%) of the cases. Staphylococcus aureus was the most isolated pathogen accounting for 57.1% (n=148) of the blood stream infections. Both the Gram positive and gram negative bacteria demonstrated increasing resistance towards among Ceftriaxone and Ampicillin. Using advanced information technology to study antimicrobial susceptibility patterns of resistant bacteria in blood culture isolates will be useful in directing empiric antibiotic therapy of severe sepsis in Uganda because laboratory data being will be collected and analyzed rapidly.