Predominance of multi-drug resistant bacterial pathogens causing surgical site infections in Muhimbili national hospital, Tanzania

被引：63

作者：

Manyahi J. ^{[1
]}

Matee M.I. ^{[1
]}

Majigo M. ^{[1
]}

Moyo S. ^{[1
]}

Mshana S.E. ^{[2
]}

Lyamuya E.F. ^{[1
]}

机构：

[1] Department of Microbiology/Immunology, Muhimbili University of Health and Allied Sciences, P. O. Box 65001, Dar es Salaam

[2] Department of Microbiology/Immunology, Catholic University of Health and Allied Sciences, P. O. Box 1464, Mwanza

来源：

BMC Research Notes | / 7卷 / 1期

关键词：

Multidrug resistance; Surgical site infections; Tanzania;

D O I：

10.1186/1756-0500-7-500

中图分类号：

学科分类号：

摘要：

Background: Surgical site infections (SSIs) remain a common and widespread problem contributing to a significant morbidity and mortality, attributed partly by the increase in antimicrobial resistance among the etiological agents. This study was done to determine the spectrum of bacterial isolates and their susceptibility patterns causing SSIs at Muhimbili National Hospital, Tanzania. Methods. This descriptive cross sectional study was conducted between September, 2011 and February, 2012. Pus swabs or pus were cultured on blood agar (Oxoid, UK) and MacConkey agar (Oxoid, UK) and incubated aerobically at 37°C for 18-24 hours. Bacterial identification was done using API 20E and VITEK and antimicrobial susceptibility was determined by Kirby Bauer disc diffusion. Results: Of the 100 patients, from whom wound swabs were collected, 90 (90%) had positive aerobic bacterial growth. A total of 147 pathogenic bacteria were isolated, including 114 (77.5%) gram negative and 33(22.5%) gram positive organisms. The most prevalent bacterial species were Pseudomonas aeruginosa (16.3%), followed by Staphylococcus aureus (12.2%) and Klebsiella pneumoniae (10.8%). Of the 18 S. aureus, 8 (44%) were methicillin resistant Staphylococcus aureus (MRSA) and three of them (17%) were carrying both MRSA and induced clindamycin resistance (ICR). Extended spectrum beta-lactamase (ESBL) producing Enterobacteriaceae were observed in 23 (79.3%) of the 29 isolates tested. Majority of Escherichia coli 12 (92.3%) and K. pneumoniae 11 (69%) isolates were ESBL producers. About 63% (93/147) were multiple-drug resistance (MDR) isolates, and the overall MDR among Gram positive and Gram negative bacteria was 60.6% (20/33) and 61.4%, (73/114), respectively. The prevalence of MDR for E. coli, A. baumannii and P. stuartii was 100% each. Majority (97%) of the Gram negative bacteria were resistant to more than four categories (classes) of antibiotics. Conclusion: A high proportion (63%) of the isolates causing SSIs in this tertiary hospital were MDR, of which (90%) were resistant to more than four classes of antibiotics. In the light of these findings, an urgent and significant change in antibiotic prescription policy is required at this National hospital. © 2014 Manyahi et al.; licensee BioMed Central Ltd.

引用

共 23 条

[1]

Mangram A.J., Horan T.C., Pearson M.L., Silver L.C., Jarvis W.R., Guideline for prevention of surgical site infection, 1999. Centers for disease control and prevention (CDC) hospital infection control practices advisory committee, Am J Infect Control, 27, pp. 97-132, (1999)

[2]

Emori T.G., Gaynes R.P., An overview of nosocomial infections, including the role of the microbiology laboratory, Clin Microbiol Rev, 6, pp. 428-442, (1993)

[3]

Weigelt J.A., Lipsky B.A., Tabak Y.P., Derby K.G., Kim M., Gupta V., Surgical site infections: Causative pathogens and associated outcomes, Am J Infect Control, 38, pp. 112-120, (2010)

[4]

Leaper D.J., Van Goor H., Reilly J., Petrosillo N., Geiss H.K., Torres A.J., Berger A., Surgical site infection - A European perspective of incidence and economic burden, Int Wound J, 1, pp. 247-273, (2004)

[5]

Le T.A., Sohn A.H., Nguyen P.T., Vo T.C., Vo V.N., Tran Nguyen T.H., Ewald B., Dibley M., Microbiology of surgical site infections and associated antimicrobial use among Vietnamese orthopedic and neurosurgical patients, Infect Control Hosp Epidemiol, 27, pp. 855-862, (2006)

[6]

Gosling R., Mbatia R., Savage A., Mulligan J.A., Reyburn H., Prevalence of hospital-acquired infections in a tertiary referral hospital in northern Tanzania, Ann Trop Med Parasitol, 97, pp. 69-73, (2003)

[7]

Mawalla B., Mshana S.E., Chalya P.L., Imirzalioglu C., Mahalu W., Predictors of surgical site infections among patients undergoing major surgery at Bugando Medical Centre in Northwestern Tanzania, BMC Surg, 11, (2011)

[8]

Fehr J., Hatz C., Soka I., Kibatala P., Urassa H., Battegay M., Jeffrey Z., Smith T., Mshinda H., Frei R., Widmer A.F., Antimicrobial prophylaxis to prevent surgical site infections in a rural sub-Saharan hospital, Clin Microbiol Infect, 12, pp. 1224-1227, (2006)

[9]

Eriksen H.M., Chugulu S., Kondo S., Lingaas E., Surgical-site infections at Kilimanjaro Christian Medical Center, J Hosp Infect, 55, pp. 14-20, (2003)

[10]

Akoko L.A., Mwanga H.A., Fredrick F., Mbembati N.M., Risk factors of surgical site infection at Muhimbili national hospital, Dar es Salaam, Tanzania, East Cent Afr J Surg, 17, 3, pp. 12-17, (2012)

← 1 2 3 →