Surveillance of antimicrobial resistance at a tertiary hospital in Tanzania

Blomberg, Björn; Mwakagile, Davis; Urassa, Willy; Maselle, Samwel Y.; Mashurano, M; Digranes, Asbjørn; Harthug, Stig; Langeland, Nina

doi:10.1186/1471-2458-4-45

Cited by 50 publications

(51 citation statements)

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“…8 However, available evidence suggests that multidrug resistance is widespread among gram-negative and gram-positive bacterial pathogens causing common infections, such as urinary and respiratory tract infections, regardless of whether they are community-or hospital-acquired. [9][10][11] Our survey of AMR among bacterial isolates from common clinical specimens obtained from patients in Kigali, Rwanda showed rather alarming rates of drug resistance among both gram-negative and gram-positive organisms, consistent with other studies from the sub-Saharan African region. [12][13][14] Using the definition of ESBL producers as being resistant to third generation cephalosporins, 15,16 31.4% and 58.7% of E. coli and Klebsiella organisms, respectively, met the criteria.…”

Section: Discussionsupporting

confidence: 88%

High Prevalence of Antimicrobial Resistance Among Common Bacterial Isolates in a Tertiary Healthcare Facility in Rwanda

Ntirenganya¹,

Manzi²,

Muvunyi³

et al. 2015

The American Journal of Tropical Medicine and Hygiene

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Abstract. Antimicrobial resistance (AMR) is a serious public health threat in both developed and developing countries. Many developing countries, including Rwanda, lack adequate surveillance systems, and therefore, the prevalence of AMR is not well-known. We conducted a prospective observational study to assess the prevalence of AMR among common bacterial isolates from clinical specimens obtained from patients on the medical wards of Kigali University Teaching Hospital (KUTH). We evaluated the antibiotic sensitivity patterns of bacterial pathogens cultured from urine, blood, sputum, and wound swab specimens obtained over a 6-month period (July 1 to December 30, 2013). There were 154 positive cultures from specimens obtained from 141 unique patients over the study period. Urine, blood, wound swab, and sputum cultures comprised 55.2%, 25.3%, 16.2%, and 3.3% of the total specimens evaluated; 31.4% and 58.7% of Escherichia coli and Klebsiella isolates, respectively, were resistant to at least one of the third generation cephalosporins. Eight percent of E. coli isolates were resistant to imipenem; 82% and 6% of Staphylococcus aureus strains were oxacillin-and vancomycin-resistant respectively. Antimicrobial resistance rates are high in Rwanda and pose a serious therapeutic challenge to the management of common infections.

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Section: Discussionsupporting

confidence: 88%

High Prevalence of Antimicrobial Resistance Among Common Bacterial Isolates in a Tertiary Healthcare Facility in Rwanda

Ntirenganya¹,

Manzi²,

Muvunyi³

et al. 2015

The American Journal of Tropical Medicine and Hygiene

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“…The high rates of resistance in Gram-negative bacteria confirm previous findings [23]. However, the frequent use of antimicrobials prior to blood culture may have biased the findings by lowering the detection rate for organisms susceptible to commonly used drugs.…”

Section: Discussionsupporting

confidence: 85%

Antimicrobial resistance predicts death in Tanzanian children with bloodstream infections: a prospective cohort study

et al. 2007

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“…These five resistance phenotypes have been reported as relatively prominent for clinical isolates obtained from children (<5 years of age) in Tanzania [25] and this pattern of multidrug resistance has been reported elsewhere in both hospital and environmental settings [23, 26–28]. Presumably, the dissemination of these resistance traits is related to the spread of mobile genetic elements such as plasmids that are widely distributed among enteric bacteria [29].…”

Section: Discussionmentioning

confidence: 88%

Comparison of antibiotic resistant Escherichia coli obtained from drinking water sources in northern Tanzania: a cross-sectional study

et al. 2016

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BackgroundAntimicrobial resistance (AMR) is a growing and significant threat to public health on a global scale. Escherichia coli comprises Gram-negative, fecal-borne pathogenic and commensal bacteria that are frequently associated with antibiotic resistance. AMR E. coli can be ingested via food, water and direct contact with fecal contamination.MethodsWe estimated the prevalence of AMR Escherichia coli from select drinking water sources in northern Tanzania. Water samples (n = 155) were collected and plated onto Hi-Crome E. coli and MacConkey agar. Presumptive E. coli were confirmed by using a uidA PCR assay. Antibiotic susceptibility breakpoint assays were used to determine the resistance patterns of each isolate for 10 antibiotics. Isolates were also characterized by select PCR genotyping and macro-restriction digest assays.Results E. coli was isolated from 71 % of the water samples, and of the 1819 E. coli tested, 46.9 % were resistant to one or more antibiotics. Resistance to ampicillin, streptomycin, sulfamethoxazole, tetracycline, and trimethoprim was significantly higher (15–30 %) compared to other tested antibiotics (0–6 %; P < 0.05). Of the β-lactam-resistant isolates, bla TEM-1 was predominant (67 %) followed by bla CTX-M (17.7 %) and bla SHV-1 (6.0 %). Among the tetracycline-resistant isolates, tet(A) was predominant (57.4 %) followed by tet(B) (24.0 %). E. coli isolates obtained from these water sources were genetically diverse with few matching macro-restriction digest patterns.ConclusionWater supplies in northern Tanzania may be a source of AMR E. coli for people and animals. Further studies are needed to identify the source of these contaminants and devise effective intervention strategies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12866-016-0870-9) contains supplementary material, which is available to authorized users.

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Surveillance of antimicrobial resistance at a tertiary hospital in Tanzania

Cited by 50 publications

References 24 publications

High Prevalence of Antimicrobial Resistance Among Common Bacterial Isolates in a Tertiary Healthcare Facility in Rwanda

High Prevalence of Antimicrobial Resistance Among Common Bacterial Isolates in a Tertiary Healthcare Facility in Rwanda

Antimicrobial resistance predicts death in Tanzanian children with bloodstream infections: a prospective cohort study

Comparison of antibiotic resistant Escherichia coli obtained from drinking water sources in northern Tanzania: a cross-sectional study

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