Bikoroti Joël Bizimanasharale, Mukambasabire Belise, Uwizeyimana Gilbert, Munyemana Jean Bosco, Mariza Jolie
Department of Surgery, University Teaching Hospital of Kigali, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda.
Department of Surgery, University Teaching Hospital of Kigali, Kigali, Rwanda.
Am J Trop Med Hyg. 2025 Apr 1;112(6):1240-1244. doi: 10.4269/ajtmh.24-0740. Print 2025 Jun 4.
Antimicrobial resistance (AMR) poses a major threat to public health worldwide. In Africa, the overall burden of AMR is not well understood or documented because of inadequate data and lack of surveillance, and empirical treatment takes a major part in the clinical management of infections. We assessed AMR in infected surgical wounds at the University Teaching Hospital of Kigali from January 1st to December 31st, 2022. The study analyzed a total of 136 swab cultures from the surgery department; 89 (65.4%) were culture positive and included in the analysis. The mean age of patients with positive culture was 37 ± 17 years old, and the sex distribution consisted of 65 males (73%) and 24 females (27%). Data were analyzed using SPSS v. 21. The study identified a diverse array of different bacterial isolates. Escherichia coli was the most prevalent (19.1%) followed by Staphylococcus aureus (17%) and Klebsiella pneumoniae (16%). Other notable isolates included Citrobacter freundii (11%), Pseudomonas aeruginosa (9%), and Acinetobacter baumannii (9%). Acinetobacter and Klebsiella had higher resistance rates of 80% and 76.5%, respectively. The average resistance rate across all isolates was 63%. Moreover, among the 89 patients who had positive swab culture results, 86 (96.6%) recovered completely, and 3 (3.4%) died. The study highlights a high level of antibiotic resistance, particularly among common Gram-negative pathogens, emphasizing the need for ongoing monitoring and the development of targeted treatment strategies to address this public health challenge.
抗菌药物耐药性（AMR）对全球公共卫生构成重大威胁。在非洲，由于数据不足和缺乏监测，AMR的总体负担尚未得到充分了解或记录，经验性治疗在感染的临床管理中占主要部分。我们评估了2022年1月1日至12月31日基加利大学教学医院感染手术伤口中的AMR情况。该研究共分析了外科的136份拭子培养物；89份（65.4%）培养结果呈阳性并纳入分析。培养结果呈阳性的患者平均年龄为37±17岁，性别分布为男性65例（73%），女性24例（27%）。使用SPSS v. 21软件进行数据分析。该研究鉴定出了各种各样不同的细菌分离株。大肠埃希菌最为常见（19.1%），其次是金黄色葡萄球菌（17%）和肺炎克雷伯菌（16%）。其他值得注意的分离株包括弗氏柠檬酸杆菌（11%）、铜绿假单胞菌（9%）和鲍曼不动杆菌（9%）。不动杆菌和克雷伯菌的耐药率较高，分别为80%和76.5%。所有分离株的平均耐药率为63%。此外，在89例拭子培养结果呈阳性的患者中，86例（96.6%）完全康复，3例（3.4%）死亡。该研究突出了抗生素耐药性的高水平，尤其是在常见革兰氏阴性病原体中，强调了持续监测以及制定针对性治疗策略以应对这一公共卫生挑战的必要性。
