Bosu Benedicta, Amponsah Obed Kwabena Offe, Tawiah Phyllis, Darko Eric, Abruquah Nana Akua, Osafo Annabella Bensusan, Sarkodie Emmanuel, Buabeng Nana Bugyei, Kapona Otridah, Owusu-Ofori Alex, Buabeng Kwame Ohene, Ayisi-Boateng Nana Kwame
University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, KNUST, Kumasi, Ghana.
JAC Antimicrob Resist. 2024 Aug 21;6(4):dlae129. doi: 10.1093/jacamr/dlae129. eCollection 2024 Aug.
Antibiograms provide effective support for empirical prescribing and antimicrobial stewardship programmes (ASPs). In low-resource settings, microbiology systems to develop antibiograms may be rudimentary or entirely lacking, which may place such facilities at a disadvantage. Notwithstanding this, facilities should use what they have to support ASPs to inform evidence-based antibiotic use. We report how an antibiogram was developed at a district hospital in Ghana to support its ASP.
This was a retrospective analysis of antibiotic susceptibility testing (AST) results from the University Hospital, KNUST from January to December 2021. Data were exported from the hospital's laboratory information system to Microsoft Excel (Version 2013). IBM SPSS Statistics (Version 25) and Epi Info™ Version 7 were used for statistical analyses.
Overall, 1949 cultures were performed, 392 (20.1%) growing bacterial pathogens. Per the CLSI M39-A4 standard guidelines for antibiograms, only 360 of the bacterial isolates were used for the analyses. The majority of isolates were from urine (187; 51.9%). Among the Gram-negative bacteria, there was low susceptibility to amoxicillin/clavulanic acid (28%), cephalosporins (11%-35%) and meropenem (21%), but high susceptibility to amikacin (96%) and levofloxacin (81%). Low susceptibility of Gram-positive isolates to amoxicillin/clavulanic acid (34%), meropenem (34%) and penicillins (27%-35%) was also recorded, but high susceptibility to ciprofloxacin (80%), gentamicin (79%) and vancomycin (76%).
High levels of bacterial resistance to cephalosporins and meropenem in the antibiogram were reported. This antibiogram highlighted the urgent need for pragmatic steps to curb antibiotic resistance through ASPs using strategies that positively improve clinicians' knowledge and prescribing practices.
抗菌谱为经验性用药和抗菌药物管理计划（ASP）提供了有效的支持。在资源匮乏的环境中，用于制定抗菌谱的微生物学系统可能很简陋或完全缺失，这可能使这些医疗机构处于不利地位。尽管如此，医疗机构应利用现有的资源来支持抗菌药物管理计划，以促进基于证据的抗生素使用。我们报告了加纳一家地区医院如何制定抗菌谱以支持其抗菌药物管理计划。
这是一项对2021年1月至12月库马西科技大学大学医院抗生素敏感性试验（AST）结果的回顾性分析。数据从医院的实验室信息系统导出到Microsoft Excel（2013版）。使用IBM SPSS Statistics（25版）和Epi Info™ 7版进行统计分析。
总体而言，共进行了1949次培养，392次（20.1%）培养出细菌病原体。根据CLSI M39 - A4抗菌谱标准指南，仅360株细菌分离株用于分析。大多数分离株来自尿液（187株；51.9%）。在革兰氏阴性菌中，对阿莫西林/克拉维酸（28%）、头孢菌素（11% - 35%）和美罗培南（21%）的敏感性较低，但对阿米卡星（96%）和左氧氟沙星（81%）的敏感性较高。革兰氏阳性分离株对阿莫西林/克拉维酸（34%）、美罗培南（34%）和青霉素（27% - 35%）的敏感性也较低，但对环丙沙星（80%）、庆大霉素（79%）和万古霉素（76%）的敏感性较高。
报告显示抗菌谱中细菌对头孢菌素和美罗培南的耐药水平较高。该抗菌谱凸显了迫切需要采取务实措施，通过抗菌药物管理计划，采用能够切实提高临床医生知识和处方实践的策略来遏制抗生素耐药性。
