Prevalence of antimicrobial drug resistant bacteria carried by in- and outpatients attending a secondary care hospital in Zambia

Abstract Objective Antimicrobial resistance is an increasing global health problem. Very little data on resistance patterns of pathogenic bacteria in low-income countries exist. The aim of this study was to measure the prevalence of antimicrobial drug resistant bacteria carried by in- and outpatient...

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Main Authors: Marjolijn M. B. Nagelkerke, Kapembwa Sikwewa, Dennis Makowa, Irene de Vries, Simon Chisi, J. Wendelien Dorigo-Zetsma
Format: Article
Language:English
Published: BMC 2017-08-01
Series:BMC Research Notes
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13104-017-2710-x
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author Marjolijn M. B. Nagelkerke
Kapembwa Sikwewa
Dennis Makowa
Irene de Vries
Simon Chisi
J. Wendelien Dorigo-Zetsma
author_facet Marjolijn M. B. Nagelkerke
Kapembwa Sikwewa
Dennis Makowa
Irene de Vries
Simon Chisi
J. Wendelien Dorigo-Zetsma
author_sort Marjolijn M. B. Nagelkerke
collection DOAJ
description Abstract Objective Antimicrobial resistance is an increasing global health problem. Very little data on resistance patterns of pathogenic bacteria in low-income countries exist. The aim of this study was to measure the prevalence of antimicrobial drug resistant bacteria carried by in- and outpatients in the resource constraint setting of a secondary care hospital in Zambia. Nasal and rectal samples from 50 in- and 50 outpatients were collected. Patients were randomly selected and informed consent was obtained. Nasal samples were tested for the presence of methicillin-resistant Staphylococcus aureus (MRSA), and rectal samples for Gram-negative rods (family of Enterobacteriaceae) non-susceptible to gentamicin, ciprofloxacin and ceftriaxone. Additionally, E-tests were performed on ceftriaxone-resistant Enterobacteriaceae to detect extended-spectrum β-lactamases (ESBLs). Results 14% of inpatients carried S. aureus, and 18% of outpatients. No MRSA was found. 90% of inpatients and 48% of outpatients carried one or more Enterobacteriaceae strains (75% Escherichia coli and Klebsiella pneumonia) resistant to gentamicin, ciprofloxacin and/or ceftriaxone (p < 0.001). Among inpatients gentamicin resistance was most prevalent (in 78%), whereas among outpatients ciprofloxacin resistance prevailed (in 38%). All ceftriaxone-resistant Enterobacteriaceae were ESBL-positive; these were present in 52% of inpatients versus 12% of outpatients (p < 0.001). We conclude it is feasible to perform basic microbiological procedures in the hospital laboratory in a low-income country and generate data on antimicrobial susceptibility. The high prevalence of antimicrobial drug resistant Enterobacteriaceae carried by in- and outpatients is worrisome. In order to slow down antimicrobial resistance, surveillance data on local susceptibility patterns of bacteria are a prerequisite to generate guidelines for antimicrobial therapy, to guide in individual patient treatment and to support implementation of infection control measures in a hospital.
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spelling doaj.art-b35c4fb0e430417da21c36de0ead5c742022-12-21T18:27:54ZengBMCBMC Research Notes1756-05002017-08-011011610.1186/s13104-017-2710-xPrevalence of antimicrobial drug resistant bacteria carried by in- and outpatients attending a secondary care hospital in ZambiaMarjolijn M. B. Nagelkerke0Kapembwa Sikwewa1Dennis Makowa2Irene de Vries3Simon Chisi4J. Wendelien Dorigo-Zetsma5Saint Francis’ HospitalSaint Francis’ HospitalSaint Francis’ HospitalSaint Francis’ HospitalSaint Francis’ HospitalDepartment of Medical Microbiology, Tergooi HospitalAbstract Objective Antimicrobial resistance is an increasing global health problem. Very little data on resistance patterns of pathogenic bacteria in low-income countries exist. The aim of this study was to measure the prevalence of antimicrobial drug resistant bacteria carried by in- and outpatients in the resource constraint setting of a secondary care hospital in Zambia. Nasal and rectal samples from 50 in- and 50 outpatients were collected. Patients were randomly selected and informed consent was obtained. Nasal samples were tested for the presence of methicillin-resistant Staphylococcus aureus (MRSA), and rectal samples for Gram-negative rods (family of Enterobacteriaceae) non-susceptible to gentamicin, ciprofloxacin and ceftriaxone. Additionally, E-tests were performed on ceftriaxone-resistant Enterobacteriaceae to detect extended-spectrum β-lactamases (ESBLs). Results 14% of inpatients carried S. aureus, and 18% of outpatients. No MRSA was found. 90% of inpatients and 48% of outpatients carried one or more Enterobacteriaceae strains (75% Escherichia coli and Klebsiella pneumonia) resistant to gentamicin, ciprofloxacin and/or ceftriaxone (p < 0.001). Among inpatients gentamicin resistance was most prevalent (in 78%), whereas among outpatients ciprofloxacin resistance prevailed (in 38%). All ceftriaxone-resistant Enterobacteriaceae were ESBL-positive; these were present in 52% of inpatients versus 12% of outpatients (p < 0.001). We conclude it is feasible to perform basic microbiological procedures in the hospital laboratory in a low-income country and generate data on antimicrobial susceptibility. The high prevalence of antimicrobial drug resistant Enterobacteriaceae carried by in- and outpatients is worrisome. In order to slow down antimicrobial resistance, surveillance data on local susceptibility patterns of bacteria are a prerequisite to generate guidelines for antimicrobial therapy, to guide in individual patient treatment and to support implementation of infection control measures in a hospital.http://link.springer.com/article/10.1186/s13104-017-2710-xAntimicrobial resistanceAntimicrobial susceptibility testingAntibiotic stewardshipCommunity carriershipHospitalizationMRSA
spellingShingle Marjolijn M. B. Nagelkerke
Kapembwa Sikwewa
Dennis Makowa
Irene de Vries
Simon Chisi
J. Wendelien Dorigo-Zetsma
Prevalence of antimicrobial drug resistant bacteria carried by in- and outpatients attending a secondary care hospital in Zambia
BMC Research Notes
Antimicrobial resistance
Antimicrobial susceptibility testing
Antibiotic stewardship
Community carriership
Hospitalization
MRSA
title Prevalence of antimicrobial drug resistant bacteria carried by in- and outpatients attending a secondary care hospital in Zambia
title_full Prevalence of antimicrobial drug resistant bacteria carried by in- and outpatients attending a secondary care hospital in Zambia
title_fullStr Prevalence of antimicrobial drug resistant bacteria carried by in- and outpatients attending a secondary care hospital in Zambia
title_full_unstemmed Prevalence of antimicrobial drug resistant bacteria carried by in- and outpatients attending a secondary care hospital in Zambia
title_short Prevalence of antimicrobial drug resistant bacteria carried by in- and outpatients attending a secondary care hospital in Zambia
title_sort prevalence of antimicrobial drug resistant bacteria carried by in and outpatients attending a secondary care hospital in zambia
topic Antimicrobial resistance
Antimicrobial susceptibility testing
Antibiotic stewardship
Community carriership
Hospitalization
MRSA
url http://link.springer.com/article/10.1186/s13104-017-2710-x
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