Bridging antimicrobial resistance knowledge gaps: The East African perspective on a global problem
Open Access
- 11 February 2019
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 14 (2), e0212131
- https://doi.org/10.1371/journal.pone.0212131
Abstract
There is worldwide concern of rapidly increasing antimicrobial resistance (AMR). However, there is paucity of resistance surveillance data and updated antibiograms in Africa in general. This study was undertaken in Kenyatta National Hospital (KNH) -the largest public tertiary referral centre in East & Central Africa—to help bridge existing AMR knowledge and practice gaps. A retrospective review of VITEK 2 (bioMérieux) records capturing antimicrobial susceptibility data for the year 2015 was done and analysed using WHONET and SPSS. Analysis of 624 isolates revealed AMR rates higher than most recent local and international reports. 88% of isolates tested were multi-drug resistant (MDR) whereas 26% were extensively-drug resistant (XDR). E. coli and K. pneumoniae had poor susceptibility to penicillins (8–48%), cephalosporins (16–43%), monobactams (17–29%), fluoroquinolones (22–44%) and trimethoprim-sulfamethoxazole (7%). Pseudomonas aeruginosa and Acinetobacter baumanii were resistant to penicillins and cephalosporins, with reduced susceptibility to carbapenems (70% and 27% respectively). S aureus had poor susceptibility to penicillins (3%) and trimethoprim-sulfamethoxazole (29%) but showed excellent susceptibility to imipenem (90%), vancomycin (97%) and linezolid (99%). The overwhelming resistance to commonly used antibiotics heralds a clarion call towards strengthening antimicrobial stewardship programmes and regular AMR regional surveillance.This publication has 18 references indexed in Scilit:
- MRSA in Africa: Filling the Global Map of Antimicrobial ResistancePLOS ONE, 2013
- Characterization of methicillin-resistant Staphylococcus aureus from skin and soft tissue infections in patients in Nairobi, KenyaInternational Journal of Infectious Diseases, 2013
- Antimicrobial resistance patterns in extended-spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae isolates in a private tertiary hospital, KenyaMicrobiology Discovery, 2013
- Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistanceClinical Microbiology & Infection, 2012
- The Bacterial Cell EnvelopeCold Spring Harbor Perspectives in Biology, 2010
- Methods for screening for methicillin-resistant Staphylococcus aureus carriageClinical Microbiology & Infection, 2009
- Waves of resistance: Staphylococcus aureus in the antibiotic eraNature Reviews Microbiology, 2009
- Nosocomial Infections at Kenyatta National Hospital Intensive-Care Unit in Nairobi, KenyaDermatology, 2006
- Does Nasal Cocolonization by Methicillin-Resistant Coagulase-Negative Staphylococci and Methicillin-Susceptible Staphylococcus aureus Strains Occur Frequently Enough To Represent a Risk of False-Positive Methicillin-Resistant S. aureus Determinations by Molecular Methods?Journal of Clinical Microbiology, 2006
- Prevalence of methicillin—resistant Staphylococcus aureus in eight African hospitals and MaltaClinical Microbiology & Infection, 2003