Mikomangwa Wigilya P, Bwire George M, Kilonzi Manase, Mlyuka Hamu, Mutagonda Ritah F, Kibanga Wema, Marealle Alphonce Ignace, Minzi Omary, Mwambete Kennedy D
Department of Clinical Pharmacy and Pharmacology, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania.
Department of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania.
Infect Drug Resist. 2020 Jun 17;13:1831-1838. doi: 10.2147/IDR.S250158. eCollection 2020.
Antibiotic resistance poses burden to the community and health-care services. Efforts are being made at local, national and global level to combat the rise of antibiotic resistance including antibiotic stewardship. Surveillance to antibiotic resistance is of importance to aid in planning and implementing infection prevention and control measures. The study was conducted to assess the resistance pattern to cefepime, clindamycin and meropenem, which are reserved antibiotics for use at tertiary hospitals in Tanzania.
A hospital-based antibiotic resistance surveillance was conducted between July and November 2019 at Muhimbili National Hospital and Bugando Medical Center, Tanzania. All organisms isolated were identified based on colony morphology, Gram staining and relevant biochemical tests. Antibiotic susceptibility testing was performed on Muller-Hinton agar using Kirby-Bauer disc diffusion method. Antibiotic susceptibility was performed according to the protocol by National Committee for Clinical Laboratory Standards.
A total of 201 clinical samples were tested in this study. Urine (39.8%, n=80) and blood (35.3%, n=71) accounted for most of the collected samples followed by pus (16.9%, n=34). The bacterial resistance to clindamycin, cefepime and meropenem was 68.9%, 73.2% and 8.5%, respectively. About 68.4% isolates were resistant to clindamycin whereby 56.3%, 75.6%, 93.8% and 100% of the tested and respectively, were cefepime resistant. About 8.5% of isolated were resistant and 6.4% had intermediate susceptibility to meropenem. Also, was resistant by 31.2% and 25% had intermediate susceptibility to meropenem.
The bacterial resistance to clindamycin and cefepime is high and low in meropenem. Henceforth, culture and susceptibility results should be used to guide the use of these antibiotics. Antibiotics with low resistance rate should be introduced to the reserve category and continuous antibiotic surveillance is warranted.
抗生素耐药性给社区和医疗服务带来负担。地方、国家和全球层面都在努力应对抗生素耐药性的上升，包括抗生素管理。对抗生素耐药性进行监测对于协助规划和实施感染预防与控制措施至关重要。本研究旨在评估头孢吡肟、克林霉素和美罗培南的耐药模式，这些是坦桑尼亚三级医院储备使用的抗生素。
2019年7月至11月在坦桑尼亚的穆希姆比利国家医院和布甘多医疗中心进行了一项基于医院的抗生素耐药性监测。所有分离出的微生物均根据菌落形态、革兰氏染色和相关生化试验进行鉴定。使用 Kirby-Bauer 纸片扩散法在 Muller-Hinton 琼脂上进行抗生素敏感性试验。抗生素敏感性试验按照美国国家临床实验室标准委员会的方案进行。
本研究共检测了201份临床样本。尿液（39.8%，n = 80）和血液（35.3%，n = 71）占所采集样本的大部分，其次是脓液（16.9%，n = 34）。细菌对克林霉素、头孢吡肟和美罗培南的耐药率分别为68.9%、73.2%和8.5%。约68.4%的分离株对克林霉素耐药，其中对头孢吡肟耐药的分别为56.3%、75.6%、93.8%和100%。约8.5%的分离株对美罗培南耐药，6.4%对美罗培南中度敏感。此外，对美罗培南耐药率为31.2%，25%对美罗培南中度敏感。
细菌对克林霉素和头孢吡肟的耐药性高，而对美罗培南的耐药性低。今后，应利用培养和药敏结果来指导这些抗生素的使用。应将耐药率低的抗生素纳入储备类别，并持续进行抗生素监测。
