Antibiogram Development in the Setting of a High Frequency of Multi-Drug Resistant Organisms at University Teaching Hospital, Lusaka, Zambia

Antibiotics

Lottie M. Hachaambwa¹  Kristen Stafford¹  Brenna M. Roth¹  Cassidy W. Claassen¹  Lloyd Mulenga²  Kaunda Yamba³  Mox Kalumbi³  J. Kristie Johnson⁴  Emily L. Heil⁵  Devang M. Patel⁶  Alexandra Laps⁷ 

[1] Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD 21201, USA;Department of Medicine, University of Zambia School of Medicine, Lusaka 10101, Zambia;Department of Pathology and Microbiology, University Teaching Hospital, Lusaka 10101, Zambia;Department of Pathology, University of Maryland School of Medicine, Baltimore, MD 21201, USA;Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA;Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA;University of Maryland School of Medicine, Baltimore, MD 21201, USA;

关键词: bacteria;    antimicrobial resistance;    multi-drug resistant organisms;    antibiogram;    antimicrobial stewardship;    Zambia;   

DOI  :  10.3390/antibiotics10070782

来源: DOAJ

【 摘 要 】

Antimicrobial resistance is a global challenge requiring reliable surveillance data collection and use. Prior studies on resistance in Zambia depended on laboratory methods with limited standardization. Since 2015, the University Teaching Hospital (UTH) microbiology laboratory has used the Vitek 2 Compact (bioMerieux, Inc., Marcy-l’Étoile, France) for standardized identification and susceptibility testing. We conducted a cross-sectional study of 2019 bacterial isolates collected from July 2015 to April 2017 to identify bacterial causes of infections, their susceptibility to commonly used antibiotics at UTH, and develop hospital antibiograms with a multidisciplinary team using World Health Organization guidance. We found high levels of antibiotic resistance among Gram negative bacteria. Escherichia coli and Klebsiella pneumoniae were highly resistant to all antibiotics except amikacin and carbapenems. E. coli had susceptibilities of 42.4% to amoxicillin/clavulanic acid, 41.4% to ceftriaxone, 40.2% to ciprofloxacin, and 10.4% to trimethoprim/sulfamethoxazole (TMP/SMX). K. pneumoniae had susceptibilities of 20.7% to amoxicillin/clavulanic acid, 15.6% to ceftriaxone, 48.5% to ciprofloxacin, and 12.3% to TMP/SMX. The high resistance to 3rd generation cephalosporins indicates high rates of beta-lactamase production. This is information that clinicians need to inform clinical decision making and choice of empiric antibiotics and that UTH requires to inform antimicrobial stewardship such as improvements in antibiotic use.

【 授权许可】

Unknown