Happiness Houka Kumburu1,2,3, Tolbert Sonda1,2,3, Blandina Theophil Mmbaga1,2,3, Michael Alifrangis4, Ole Lund5, Gibson Kibiki3,6, Frank M Aarestrup7. 1. Kilimanjaro Clinical Research Institute, Moshi, Tanzania. 2. Kilimanjaro Christian Medical Centre, Moshi, Tanzania. 3. Kilimanjaro Christian Medical University College, Moshi, Tanzania. 4. Centre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark. 5. Centre for Biological Sequence Analysis, Department of Bioinformatics, Technical University of Denmark, Copenhagen, Denmark. 6. East African Health Research Commission, Bujumbura, Burundi. 7. DTU-Food, Technical University of Denmark, Copenhagen, Denmark.
Abstract
OBJECTIVE: To determine the causative agents of infections and their antimicrobial susceptibility at a tertiary care hospital in Moshi, Tanzania, to guide optimal treatment. METHODS: A total of 590 specimens (stool (56), sputum (122), blood (126) and wound swabs (286)) were collected from 575 patients admitted in the medical and surgical departments. The bacterial species were determined by conventional methods, and disc diffusion was used to determine the antimicrobial susceptibility pattern of the bacterial isolates. RESULTS: A total of 249 (42.2%) specimens were culture-positive yielding a total of 377 isolates. A wide range of bacteria was isolated, the most predominant being Gram-negative bacteria: Proteus spp. (n = 48, 12.7%), Escherichia coli (n = 44, 11.7%), Pseudomonas spp. (n = 40, 10.6%) and Klebsiella spp (n = 38, 10.1%). Wound infections were characterised by multiple isolates (n = 293, 77.7%), with the most frequent being Proteus spp. (n = 44, 15%), Pseudomonas (n = 37, 12.6%), Staphylococcus (n = 29, 9.9%) and Klebsiella spp. (n = 28, 9.6%). All Staphylococcus aureus tested were resistant to penicillin (n = 22, 100%) and susceptible to vancomycin. Significant resistance to cephalosporins such as cefazolin (n = 62, 72.9%), ceftriaxone (n = 44, 51.8%) and ceftazidime (n = 40, 37.4%) was observed in Gram-negative bacteria, as well as resistance to cefoxitin (n = 6, 27.3%) in S. aureus. CONCLUSION: The study has revealed a wide range of causative agents, with an alarming rate of resistance to the commonly used antimicrobial agents. Furthermore, the bacterial spectrum differs from those often observed in high-income countries. This highlights the imperative of regular generation of data on aetiological agents and their antimicrobial susceptibility patterns especially in infectious disease endemic settings. The key steps would be to ensure the diagnostic capacity at a sufficient number of sites and implement structures to routinely exchange, compare, analyse and report data. Sentinel sites (hospitals) across the country (and region) should report on a representative subset of bacterial species and their susceptibility to drugs at least annually. A central organising body should collate the data and report to relevant national and international stakeholders.
OBJECTIVE: To determine the causative agents of infections and their antimicrobial susceptibility at a tertiary care hospital in Moshi, Tanzania, to guide optimal treatment. METHODS: A total of 590 specimens (stool (56), sputum (122), blood (126) and wound swabs (286)) were collected from 575 patients admitted in the medical and surgical departments. The bacterial species were determined by conventional methods, and disc diffusion was used to determine the antimicrobial susceptibility pattern of the bacterial isolates. RESULTS: A total of 249 (42.2%) specimens were culture-positive yielding a total of 377 isolates. A wide range of bacteria was isolated, the most predominant being Gram-negative bacteria: Proteus spp. (n = 48, 12.7%), Escherichia coli (n = 44, 11.7%), Pseudomonas spp. (n = 40, 10.6%) and Klebsiella spp (n = 38, 10.1%). Wound infections were characterised by multiple isolates (n = 293, 77.7%), with the most frequent being Proteus spp. (n = 44, 15%), Pseudomonas (n = 37, 12.6%), Staphylococcus (n = 29, 9.9%) and Klebsiella spp. (n = 28, 9.6%). All Staphylococcus aureus tested were resistant to penicillin (n = 22, 100%) and susceptible to vancomycin. Significant resistance to cephalosporins such as cefazolin (n = 62, 72.9%), ceftriaxone (n = 44, 51.8%) and ceftazidime (n = 40, 37.4%) was observed in Gram-negative bacteria, as well as resistance to cefoxitin (n = 6, 27.3%) in S. aureus. CONCLUSION: The study has revealed a wide range of causative agents, with an alarming rate of resistance to the commonly used antimicrobial agents. Furthermore, the bacterial spectrum differs from those often observed in high-income countries. This highlights the imperative of regular generation of data on aetiological agents and their antimicrobial susceptibility patterns especially in infectious disease endemic settings. The key steps would be to ensure the diagnostic capacity at a sufficient number of sites and implement structures to routinely exchange, compare, analyse and report data. Sentinel sites (hospitals) across the country (and region) should report on a representative subset of bacterial species and their susceptibility to drugs at least annually. A central organising body should collate the data and report to relevant national and international stakeholders.
Authors: Collins K Boahen; Godfrey S Temba; Vesla I Kullaya; Vasiliki Matzaraki; Leo A B Joosten; Gibson Kibiki; Blandina T Mmbaga; Andre van der Ven; Quirijn de Mast; Mihai G Netea; Vinod Kumar Journal: Am J Hum Genet Date: 2022-02-14 Impact factor: 11.043
Authors: Tolbert Sonda; Happiness Kumburu; Marco van Zwetselaar; Michael Alifrangis; Blandina T Mmbaga; Ole Lund; Gibson S Kibiki; Frank M Aarestrup Journal: Eur J Clin Microbiol Infect Dis Date: 2018-07-20 Impact factor: 3.267
Authors: Tolbert Sonda; Happiness Kumburu; Marco van Zwetselaar; Michael Alifrangis; Blandina T Mmbaga; Frank M Aarestrup; Gibson Kibiki; Ole Lund Journal: Antimicrob Resist Infect Control Date: 2018-06-08 Impact factor: 4.887
Authors: Tolbert Sonda; Happiness Kumburu; Marco van Zwetselaar; Michael Alifrangis; Blandina T Mmbaga; Ole Lund; Frank M Aarestrup; Gibson Kibiki Journal: Eur J Clin Microbiol Infect Dis Date: 2018-02-20 Impact factor: 3.267
Authors: Brenna M Roth; Alexandra Laps; Kaunda Yamba; Emily L Heil; J Kristie Johnson; Kristen Stafford; Lottie M Hachaambwa; Mox Kalumbi; Lloyd Mulenga; Devang M Patel; Cassidy W Claassen Journal: Antibiotics (Basel) Date: 2021-06-28
Authors: Nicholas Agyepong; Usha Govinden; Alex Owusu-Ofori; Sabiha Yusuf Essack Journal: Antimicrob Resist Infect Control Date: 2018-03-09 Impact factor: 4.887
Authors: Happiness H Kumburu; Tolbert Sonda; Pimlapas Leekitcharoenphon; Marco van Zwetselaar; Oksana Lukjancenko; Michael Alifrangis; Ole Lund; Blandina T Mmbaga; Gibson Kibiki; Frank M Aarestrup Journal: Biomed Res Int Date: 2018-01-02 Impact factor: 3.411