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Hambali KU, Eilu E, Kumar S, Afolabi AO, Tijani NA, Faseun YO, Odoki M, Gechemba Mokaya C, Makeri D, Jakheng SPE, Sankarapandian V, Adeyemo RO, Adegboyega TT, Adebayo IA, Ntulume I, Akinola SA. Monitoring Multi-Drug Resistant Klebsiella pneumoniae in Kitagata Hot Spring, Southwestern Uganda: A Public Health Implication. Infect Drug Resist 2024; 17:3325-3341. [PMID: 39131514 PMCID: PMC11315647 DOI: 10.2147/idr.s472998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 07/31/2024] [Indexed: 08/13/2024] Open
Abstract
Background The concerning frequency of K. pneumoniae in various recreational settings, is noteworthy, especially regarding multi-drug resistant (MDR) strains. This superbug is linked to the rapid spread of plasmids carrying these resistance genes. The objective of this study was to evaluate the spatiotemporal prevalence of MDR-K. pneumoniae in the Kitagata hot spring, Southwestern Uganda. Methods A laboratory-based descriptive longitudinal study was conducted between May and July 2023. During rainy and dry seasons, we collected eighty water samples in the morning and evening from the hot spring. The temperature at each point was measured prior to sample collection, and two samples were obtained at varying depths. 5 mL of each homogenized sample were pre-enriched in brain heart infusion broth, and subsequently in both blood and violet red bile agar. The Kirby-Bauer disk diffusion method was performed, followed by the detection of carbapenemase (CR) and extended-spectrum β-lactamase (ESBL) production. Polymerase chain reaction showed resistance genes viz. bla TEM, bla CTX-M and bla KPC. Data were analyzed using SPSS-20 to obtain chi-square tests and regression analysis. Results K. pneumoniae accounted for 30.0% of isolates obtained from Kitagata hot springs, with all isolates classified as multi-drug resistant. All isolates were resistant to ampicillin, rifampicin, ceftazidime, and azithromycin (79.2%). Additionally, 95.8% of isolates harbored bla TEM gene alone and both bla TEM and bla CTX genes, followed by bla KPC alone (33.3%), with 25% harboring all three resistance genes. During the dry season, K. pneumoniae had a higher prevalence (35.0%) compared to the wet season (25.0%). The prevalence of MDR-K. pneumoniae significantly increased over the course of the study. The presence of the three studied resistance genes in the isolates showed a positive correlation with the second phase of sample collection and the dry season but exhibited a negative correlation with temperature, except for isolates harboring either bla TEM alone or bla TEM+KPC+CTX genes. Conclusion Kitagata hot spring serves as a hotspot for continuous dissemination and acquisition of MDR-K. pneumoniae harboring resistance genes that encode for ESBL and CR production. The healthcare sector ought to implement an ongoing monitoring and surveillance system as well as robust antimicrobial resistance stewardship programs aimed at delivering health education to the community.
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Affiliation(s)
- Kaltume Umar Hambali
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Emmanuel Eilu
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Sunil Kumar
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Abdullateef Opeyemi Afolabi
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Naheem Adekilekun Tijani
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Yusuf Olusola Faseun
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Martin Odoki
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Christine Gechemba Mokaya
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Danladi Makeri
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | | | - Vidya Sankarapandian
- Department of Medical Microbiology and Immunology, Kampala International University-Western Campus, Ishaka-Bushenyi, Uganda
| | - Rasheed Omotayo Adeyemo
- Department of Microbiology and Parasitology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda
| | - Taofeek Tope Adegboyega
- Department of Microbiology and Parasitology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda
| | - Ismail Abiola Adebayo
- Department of Medical Biochemistry, Molecular Biology and Genetics, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda
| | - Ibrahim Ntulume
- School of Biosecurity Biotechnical and Laboratory Sciences, College of Medicine and Veterinary Medicine, Makerere University, Kampala, Uganda
| | - Saheed Adekunle Akinola
- Department of Microbiology and Parasitology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda
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Vougat Ngom R, Jajere SM, Ayissi GJ, Tanyienow A, Moffo F, Watsop HM, Mimboe LM, Mouiche MM, Schüpbach-Regula G, Carmo LP. Unveiling the landscape of resistance against high priority critically important antimicrobials in food-producing animals across Africa: A scoping review. Prev Vet Med 2024; 226:106173. [PMID: 38503073 DOI: 10.1016/j.prevetmed.2024.106173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 02/10/2024] [Accepted: 03/06/2024] [Indexed: 03/21/2024]
Abstract
The rapid population growth in Africa is associated with an increasing demand for livestock products which in turn can lead to antimicrobial use. Antimicrobial usage in animals contributes to the emergence and selection of resistant bacteria which constitutes a serious public health threat. This study aims to review and summarize the available information on highest priority critically important antimicrobials (HPCIAs) resistance in livestock production in Africa. This work will help to inform future policies for controlling antimicrobial resistance (AMR) in the food production chain. A scoping review was conducted according to the Cochrane handbook and following PRISMA 2020 guidelines for reporting. Primary research studies published after 1999 and reporting resistance of Escherichia coli, Enterococcus spp, Staphylococcus aureus, Salmonella spp, and Campylobacter spp to HPCIAs in poultry, cattle, pigs, goats, and sheep in Africa were searched in four databases. A total of 312 articles were included in the review. The majority of the studies (40.7) were conducted in North African countries. More than 49.0% of included studies involved poultry and 26.2% cattle. Cephalosporins and quinolones were the most studied antimicrobial classes. Of the bacteria investigated in the current review, E. coli (41.7%) and Salmonella spp (24.9%) represented the most commonly studied. High levels of resistance against erythromycin in E. coli were found in poultry (MR 96.1%, IQR 83.3-100.0%), cattle (MR 85.7%, IQR 69.2-100.0%), and pigs (MR 94.0%, IQR 86.2-94.0%). In sheep, a high level of resistance was observed in E. coli against nalidixic acid (MR 87.5%, IQR 81.3-93.8%). In goats, the low level of sensibility was noted in S. aureus against streptomycin (MR 86.8%, IQR 19.4-99.0%). The study provides valuable information on HPCIAs resistance in livestock production in Africa and highlights the need for further research and policies to address the public health risk of AMR. This will likely require an investment in diagnostic infrastructure across the continent. Awareness on the harmful impact of AMR in African countries is a requirement to produce more effective and sustainable measures to curb AMR.
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Affiliation(s)
- Ronald Vougat Ngom
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Saleh M Jajere
- Faculty of Veterinary Medicine, University of Maiduguri, Borno State, Nigeria
| | - Gaspard Ja Ayissi
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Akenghe Tanyienow
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Frédéric Moffo
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Hippolyte M Watsop
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Leina M Mimboe
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Mohamed Mm Mouiche
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | | | - Luís Pedro Carmo
- Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Bern, Switzerland; Norwegian Veterinary Institute, Elizabeth Stephansens vei 1, Ås 1433, Norway
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Nabidda S, Ssennyonjo R, Atwaru J, Kanyike AM, Baryayaka S, Pangholi K, Tusiimire J. Antimicrobial resistance and rational prescription practices: knowledge, perceptions and confidence of health profession interns in Uganda. JAC Antimicrob Resist 2023; 5:dlad105. [PMID: 37795426 PMCID: PMC10546811 DOI: 10.1093/jacamr/dlad105] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 09/12/2023] [Indexed: 10/06/2023] Open
Abstract
Background Antimicrobial resistance (AMR) is significantly driven by misuse and overuse of antibiotics. Graduate health profession interns often prescribe antimicrobials under minimum supervision. Objectives This study explored the knowledge, perceptions and confidence of health profession interns in Uganda regarding AMR and rational prescription practices. Methods This was a cross-sectional survey employing quantitative techniques carried out between October and November 2022 at six tertiary hospitals in Uganda. Health profession interns including doctors, nurses, midwives and pharmacists were recruited as study participants. Data were collected using online Kobo toolbox software. Data analysis was performed using STATA (StataCorp) version 16. Bivariate analysis and multivariable logistic regression were performed. P < 0.05 was considered statistically significant. Results We recruited 281 participants with a mean age of 27 ± 3.8 years, of which few (n = 53; 19%) had good knowledge about AMR and rational prescription. The use of professional organization guidelines as a source of information was significantly associated with good knowledge (adjusted OR = 1.9; 95% CI: 1.0-3.5; P = 0.046). Nurses had the least knowledge compared with doctors and pharmacists. Continuous medical education (99%) and availability of clinical guidelines (98%) were identified as the most helpful intervention to improve knowledge. Most participants were confident about accurately diagnosing infections and sepsis and selecting appropriate antimicrobials. Conclusions Continuous medical education and availability of clinical and professional organization guidelines should be leveraged to improve the knowledge of AMR and rational prescription among health profession interns. Their high confidence in rational prescription practices should be pivotal to the fight against AMR.
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Affiliation(s)
- Shamim Nabidda
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Aga Khan University, Kampala, Uganda
| | | | - Joseph Atwaru
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Andrew Marvin Kanyike
- Faculty of Health Sciences, Busitema University, Mbale, Uganda
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
| | - Shiellah Baryayaka
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Jonans Tusiimire
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
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Muleme J, Kankya C, Munyeme M, Musoke D, Ssempebwa JC, Isunju JB, Wambi R, Balugaba BE, Sekulima T, Mugambe RK, Cadmus S, Kajumbula HM. Phenotypic Characterization and Antibiograms of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli Isolated at the Human-Animal-Environment Interface Using a One Health Approach Among Households in Wakiso District, Uganda. Infect Drug Resist 2023; 16:2203-2216. [PMID: 37081947 PMCID: PMC10112474 DOI: 10.2147/idr.s398951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/01/2023] [Indexed: 04/22/2023] Open
Abstract
Background The occurrence of extended spectrum beta-lactamase (ESBL) producing bacteria such as Escherichia coli has increasingly become recognized beyond hospital settings. Resistance to other types of antibiotics limits treatment options while the existence of such bacteria among humans, animals, and the environment is suggestive of potential zoonotic and reverse-zoonotic transmission. This study aimed to establish the antibiotic susceptibility profiles of the ESBL-producing Escherichia coli (ESBL-EC) from human, animal, and environmental isolates obtained among farming households within Wakiso district using a One Health approach. Methods A total of 100 ESBL-EC isolates from humans 35/100 (35%), animals 56/100 (56%), and the environment 9/100 (9%) were tested for susceptibility to 11 antibiotics. This was done using the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Data were analyzed in STATA ver. 16 and graphs were drawn in Microsoft excel ver. 10. Results Most of the ESBL-EC isolates (98%) were resistant to more than two antibiotics. ESBL-EC isolates were most susceptible to meropenem (MEM) (88.0%), and imipenem (82.0%) followed by gentamicin (72%). ESBL-EC isolates from humans were most susceptible to meropenem (MEM) followed by imipenem (IPM)> gentamicin (CN)> ciprofloxacin (CIP). Animal samples were more susceptible to MEM, IPM, and CN but were highly resistant to cefotaxime (CTX)> cefepime (FEP)>other antibiotics. Multidrug resistance (MDR) was mostly reported among households keeping goats under intensive husbandry practices. Seven percent of the isolates exhibited carbapenem resistance while 22% showed aminoglycoside resistance. Similar resistance patterns among humans, animals, and environmental samples were also reported. Conclusion Our study provides baseline information on non-hospital-based MDR caused by ESBL-EC using a One Health approach. ESBL-EC isolates were prevalent among apparently healthy community members, animals, and their environment. It is important to conduct more One Health approach studies to generate evidence on the drivers, resistance patterns, and transmission of ESBL-producing organisms at the human-animal-environmental interface.
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Affiliation(s)
- James Muleme
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
- Department of Biosecurity Ecosystems and Veterinary Public Health, Makerere University College of Veterinary Medicine Animal Resources and Biosecurity, Kampala, Uganda
- Correspondence: James Muleme, Email
| | - Clovice Kankya
- Department of Biosecurity Ecosystems and Veterinary Public Health, Makerere University College of Veterinary Medicine Animal Resources and Biosecurity, Kampala, Uganda
| | - Musso Munyeme
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - David Musoke
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - John C Ssempebwa
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Rogers Wambi
- Department of Biosecurity Ecosystems and Veterinary Public Health, Makerere University College of Veterinary Medicine Animal Resources and Biosecurity, Kampala, Uganda
- Department of Clinical Laboratory, Mulago National Referral Hospital, Kampala, Uganda
| | - Bonny Enock Balugaba
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Tahalu Sekulima
- Department of Biotechnical and Diagnostic Sciences, Veterinary Microbiology Research Laboratory, College of Veterinary Medicine, Animal Resources and Biosecurity, Kampala, Uganda
| | - Richard K Mugambe
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Simeon Cadmus
- Department of Veterinary Public Health and Preventive Medicine, Center for Control and Prevention of Zoonoses, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
| | - Henry M Kajumbula
- Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
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Kanyike AM, Olum R, Kajjimu J, Owembabazi S, Ojilong D, Nassozi DR, Amongin JF, Atulinda L, Agaba K, Agira D, Wamala NK, Buule R, Nabukeera G, Kyomuhendo R, Luwano R, Owobusingye W, Matovu D, Musoke P, Bongomin F, Kiyimba K. Antimicrobial resistance and rational use of medicine: knowledge, perceptions, and training of clinical health professions students in Uganda. Antimicrob Resist Infect Control 2022; 11:145. [PMID: 36434685 PMCID: PMC9700951 DOI: 10.1186/s13756-022-01186-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 11/17/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) is an important global health concern, projected to contribute to significant mortality, particularly in developing countries. This study aimed to determine the knowledge, perceptions of clinical health professions students towards antimicrobial resistance and rational use of medicine and confidence level to prescribe antimicrobials. METHODS An online descriptive cross-sectional survey was conducted among clinical health professions students across 9 medical schools in Uganda. A semi-structured questionnaire using Kobo Toolbox form was shared among participants via WhatsApp Messenger (Meta, California, USA). Knowledge was categorized using modified Bloom's cut-off. One-way ANOVA, Chi-square or Fisher's exact test, and logistic regression were used to assess the association between dependent and independent variables. A p < 0.05 was considered statistically significant. RESULTS We surveyed 681 participants, most were pursuing a Bachelor of Medicine and Surgery degree (n = 433, 63.6%), with a mean age of 24 (standard deviation: 3.6) years. Most participants (n = 596, 87.5%) had sufficient knowledge about antimicrobial resistance with a mean score of 85 ± 14.2%. There was a significant difference in mean knowledge scores of year 4 (86.6%) compared to year 3 (82.4%) (p = 0.002) and year 5 (88.0%) compared to year 3 (82.4%) (p < 0.001). Most participants (n = 456, 66.9%), were confident on making an accurate diagnosis of infection, and choosing the correct antimicrobial agent to use (n = 484, 71.1%). CONCLUSION Health profession students exhibited good knowledge on antimicrobial resistance and high self-perceived confidence that should be leveraged to foster better future antimicrobial prescription practices. However, they still agreed that a separated course unit on AMR is necessary which responsible authorities should consider to consolidate the efforts.
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Affiliation(s)
- Andrew Marvin Kanyike
- grid.448602.c0000 0004 0367 1045Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Ronald Olum
- grid.11194.3c0000 0004 0620 0548School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Jonathan Kajjimu
- grid.33440.300000 0001 0232 6272Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Shebah Owembabazi
- grid.448602.c0000 0004 0367 1045Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Daniel Ojilong
- grid.448602.c0000 0004 0367 1045Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Dianah Rhoda Nassozi
- grid.11194.3c0000 0004 0620 0548School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Linda Atulinda
- grid.11194.3c0000 0004 0620 0548School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Kenneth Agaba
- grid.33440.300000 0001 0232 6272Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Drake Agira
- grid.449527.90000 0004 0534 1218School of Medicine, Kabale University, Kabale, Uganda
| | - Nicholas Kisaakye Wamala
- grid.440478.b0000 0004 0648 1247Faculty of Clinical Medicine and Dentistry, Kampala International University, Ishaka-Bushenyi, Uganda
| | - Richard Buule
- grid.440478.b0000 0004 0648 1247Faculty of Clinical Medicine and Dentistry, Kampala International University, Ishaka-Bushenyi, Uganda
| | - Germinah Nabukeera
- grid.449527.90000 0004 0534 1218School of Medicine, Kabale University, Kabale, Uganda
| | - Robert Kyomuhendo
- grid.442626.00000 0001 0750 0866Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Rehema Luwano
- grid.442655.40000 0001 0042 4901Faculty of Medicine, Islamic University in Uganda, Mbale, Uganda
| | - Whitney Owobusingye
- grid.448548.10000 0004 0466 5982Faculty of Nursing and Health Sciences, Bishop Stuart University, Mbarara, Uganda
| | - Dissan Matovu
- Faculty of Biology, Medicine and Health, King Ceaser University, Kampala, Uganda
| | - Philip Musoke
- grid.11194.3c0000 0004 0620 0548School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Felix Bongomin
- grid.442626.00000 0001 0750 0866Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Kenedy Kiyimba
- grid.448602.c0000 0004 0367 1045Department of Pharmacology and Therapeutics, Faculty of Health Sciences, Busitema University, Mbale, Uganda
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Kanth S, Puttaiahgowda YM. CURRENT STATE AND FUTURE PERSPECTIVES OF STARCH DERIVATIVES AND THEIR BLENDS AS ANTIMICROBIAL MATERIALS. STARCH-STARKE 2022. [DOI: 10.1002/star.202200001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Shreya Kanth
- Department of Chemistry Manipal Institute of Technology Manipal Academy of Higher Education Manipal 576104 India
| | - Yashoda Malgar Puttaiahgowda
- Department of Chemistry Manipal Institute of Technology Manipal Academy of Higher Education Manipal 576104 India
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Chaplain D, Asutaku BB, Mona M, Bulafu D, Aruhomukama D. The need to improve antimicrobial susceptibility testing capacity in Ugandan health facilities: insights from a surveillance primer. Antimicrob Resist Infect Control 2022; 11:23. [PMID: 35115045 PMCID: PMC8812180 DOI: 10.1186/s13756-022-01072-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 01/23/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Lab-based surveillance (LBS) of antimicrobial resistance (AMR) is not systematically implemented in Uganda. We aimed to identify the gaps in establishing regular LBS of AMR in Uganda. METHODS This was a retrospective records review. It was done at Mulago Hospital (MH) Microbiology Lab (MHL). It analyzed lab records on bacteria and their antimicrobial susceptibility profiles (ASPs) over 6 months. Since MH is the national referral hospital, we hypothesized that (1) MHL is the best resourced and that any limitations seen here are amplified in labs at regional referral hospitals (RRHs) and health centers (HCs); (2) data from MHL on LBS mirrors that from labs at RRHs and HCs; (3) the state of records from MHL show lab performance and the presence or absence of standard operating procedures (SOPs), as would be the case at RRHs and HCs. RESULTS The lab got 1760 samples over the six months. The most common sample was urine (659, 37.4%). From the 1760 samples, data on 478 bacterial isolates were available. Urine gave the most isolates (159, 33.3%). Most of the isolates were gram-negative (267, 55.9%). Escherichia coli (100, 37%) was the most common gram-negative (of the Enterobacteriaceae). Pseudomonas aeruginosa (17, 6%) was the most common gram-negative (of the non-Enterobacteriaceae). The gram-negative bacteria were highly resistant to β-lactams. These were highly sensitive to carbapenems. The Staphylococcus aureus were highly resistant to β-lactams. The gram-positive bacteria were highly sensitive to vancomycin. ASPs for all bacterial categories were incomplete. CONCLUSIONS The findings from MHL suggest that there is a need to improve antimicrobial susceptibility testing capacity. They also suggest that the situation at RRHs and HCs around the country could be worse. So, there is a need to extend the political will, which already exists, into operational and implementation action.
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Affiliation(s)
- Duku Chaplain
- Clinical Microbiology Laboratory, Mulago National Referral Hospital, Kampala, Uganda
| | - Butti Ben Asutaku
- Clinical Microbiology Laboratory, Mulago National Referral Hospital, Kampala, Uganda
| | - Muhammad Mona
- Clinical Microbiology Laboratory, Mulago National Referral Hospital, Kampala, Uganda
| | - Douglas Bulafu
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Dickson Aruhomukama
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
- Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
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