title: Bloodstream infections caused by resistant bacteria in surgical patients admitted to Modilon Hospital, Madang.
abstract: In view of the dearth of information relating to antibiotic resistance in community- and hospital-acquired bacterial infections in Papua New Guinea (PNG), we carried out a prospective, hospital-based observational study of surgical patients between October 2008 and October 2009. In a sample of 115 patients (median age 30 years; 55% males) suspected of having a bloodstream infection, blood cultures were positive in 11 (10%) and a significant pathogen was isolated in 9 (8%). Staphylococcus aureus was isolated in 4 patients (44%) and 3 were methicillin resistant; all these isolates were considered community acquired because cultures were performed within 48 hours of admission. Of the remaining 5 isolates, 4 were Gram-negative organisms with at least intermediate resistance to chloramphenicol that were grown from blood taken > 48 hours post-admission and thus considered nosocomially acquired. These data suggest two distinct patterns of bacterial infection in PNG surgical inpatients that have implications for national antibiotic prescription guidelines.
authors.forename: Henao
authors.initials: H
authors.lastname: Asa
authors.forename: Moses
authors.initials: M
authors.lastname: Laman
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Greenhill
authors.forename: Peter M
authors.initials: PM
authors.lastname: Siba
authors.forename: Timothy M E
authors.initials: TM
authors.lastname: Davis
authors.forename: John
authors.initials: J
authors.lastname: Maihua
authors.forename: Laurens
authors.initials: L
authors.lastname: Manning
mesh_terms: D000293:Adolescent; D000328:Adult; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D002648:Child; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D010219:Papua New Guinea; D011446:Prospective Studies; D013514:Surgical Procedures, Operative; D055815:Young Adult