title: High prevalence of antimicrobial resistance among common bacterial isolates in a tertiary healthcare facility in Rwanda.
abstract: Antimicrobial resistance (AMR) is a serious public health threat in both developed and developing countries. Many developing countries, including Rwanda, lack adequate surveillance systems, and therefore, the prevalence of AMR is not well-known. We conducted a prospective observational study to assess the prevalence of AMR among common bacterial isolates from clinical specimens obtained from patients on the medical wards of Kigali University Teaching Hospital (KUTH). We evaluated the antibiotic sensitivity patterns of bacterial pathogens cultured from urine, blood, sputum, and wound swab specimens obtained over a 6-month period (July 1 to December 30, 2013). There were 154 positive cultures from specimens obtained from 141 unique patients over the study period. Urine, blood, wound swab, and sputum cultures comprised 55.2%, 25.3%, 16.2%, and 3.3% of the total specimens evaluated; 31.4% and 58.7% of Escherichia coli and Klebsiella isolates, respectively, were resistant to at least one of the third generation cephalosporins. Eight percent of E. coli isolates were resistant to imipenem; 82% and 6% of Staphylococcus aureus strains were oxacillin- and vancomycin-resistant respectively. Antimicrobial resistance rates are high in Rwanda and pose a serious therapeutic challenge to the management of common infections.
authors: Department of Medicine, Kigali University Teaching Hospital, Kigali, Rwanda; Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda; Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut.
authors: Cyprien
authors: C
authors: Ntirenganya
authors: Department of Medicine, Kigali University Teaching Hospital, Kigali, Rwanda; Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda; Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut.
authors: Olivier
authors: O
authors: Manzi
authors: Department of Medicine, Kigali University Teaching Hospital, Kigali, Rwanda; Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda; Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut.
authors: Claude Mambo
authors: CM
authors: Muvunyi
authors: Department of Medicine, Kigali University Teaching Hospital, Kigali, Rwanda; Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda; Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut onyema.ogbuagu@yale.edu.
authors: Onyema
authors: O
authors: Ogbuagu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012432:Rwanda / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D063128:Tertiary Health Care; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents
references: Curr Issues Mol Biol. 2015;17:11-21
references: 24821872
references: J Clin Microbiol. 2012 Feb;50(2):525-7
references: 22116157
references: J Antimicrob Chemother. 2001 Jul;48 Suppl 1:87-102
references: 11420342
references: Clin Infect Dis. 2001 Sep 15;33 Suppl 3:S124-9
references: 11524708
references: Int J Antimicrob Agents. 2002 Feb;19(2):125-32
references: 11850165
references: Clin Microbiol Infect. 2003 Feb;9(2):153-6
references: 12588338
references: Clin Microbiol Infect. 2004 Aug;10(8):762-5
references: 15301683
references: J Clin Microbiol. 2012 Feb;50(2):312-7
references: 22162561
references: Clin Ther. 2012 Jan;34(1):124-37
references: 22154196
references: Clin Microbiol Rev. 2012 Oct;25(4):682-707
references: 23034326
references: Stud Fam Plann. 2012 Jun;43(2):153-8
references: 23175954
references: Clin Microbiol Infect. 2013 Jan;19(1):70-6
references: 22268620
references: Afr Health Sci. 2012 Sep;12(3):368-75
references: 23382754
references: Int J Infect Dis. 2013 Feb;17(2):e115-9
references: 23092752
references: S Afr Med J. 2000 Nov;90(11):1113
references: 11196030
references: BMC Public Health. 2004 Oct 11;4:45
references: 15476559
references: Acc Chem Res. 2006 Oct;39(10):721-8
references: 17042472
references: J Clin Microbiol. 2007 Jan;45(1):199-205
references: 17079502
references: Afr Health Sci. 2006 Dec;6(4):232-5
references: 17604512
references: S Afr Med J. 2008 Aug;98(8):586, 588, 590 passim
references: 18928032
references: Ethiop Med J. 2008 Jul;46(3):227-35
references: 19271386
references: PLoS One. 2013;8(7):e68024
references: 23922652
references: PLoS One. 2013;8(7):e68721
references: 23935883
references: Am J Trop Med Hyg. 2013 Nov;89(5):960-4
references: 24043693
references: Rev Inst Med Trop Sao Paulo. 2014 Jan-Feb;56(1):55-9
references: 24553609
references: J Antimicrob Chemother. 2014 Sep;69(9):2337-53
references: 24879668
references: J Infect Dev Ctries. 2007;1(3):257-62
references: 19734602
references: J Infect Dev Ctries. 2009;3(4):295-9
references: 19759493
references: Tanzan J Health Res. 2009 Jul;11(3):154-9
references: 20734713
references: Trop Med Int Health. 2011 Feb;16(2):145-51
references: 21078009
references: Am J Trop Med Hyg. 2011 Jun;84(6):923-8
references: 21633029
references: Med Mal Infect. 2011 Dec;41(12):646-51
references: 22033230
references: BMC Res Notes. 2013;6:298
references: 23890206