title: Comparison of antimicrobial resistance patterns of ESBL and non ESBL bacterial isolates among patients with secondary peritonitis at Bugando Medical Centre, Mwanza - Tanzania.
abstract: Secondary peritonitis is a common surgical emergence with deadly outcomes when not timely and promptly intervened. The emergence of Extended spectrum beta lactamase producing bacteria (ESBL) poses treatment challenge at Bugando Medical Centre (BMC); hence a need to evaluate the magnitude of ESBL so as to guide specific therapy.
  
  
  
  This was a cross sectional study conducted at BMC from May 2014 to April 2015 involving patients with secondary peritonitis. A questionnaire was used to collect patients' information. Peritoneal aspirate sample was collected intra-operatively and processed using standard operating procedures to identify bacteria species and their susceptibility profiles.
  
  
  
  The study involved 97 patients with the median age (IQR) of 32 (21-47) years, males were 62 (63.9 %) and about 27 (27.8 %) patients had co-morbid illnesses. The prevalence of ESBL among patients with secondary peritonitis was 23.7 % (23/97). Of 53 gram negative Enterobacteriaceae isolated, 47.2 % (25/53) were ESBL producers, with predominance of Escherichia coli 7 (28.0 %) and Klebsiella spp 5 (20.0 %). The ESBL isolates exhibited more resistance rates to trimethoprim sulfamethoxazole and ciprofloxacin compared to non ESBL isolates 96.0 % versus 60.7 %, p value = 0.003 and 16.0 % versus 0.0 %, p value = 0.043 respectively). All isolates were sensitive to meropenem.
  
  
  
  The prevalence of ESBL among patients with secondary peritonitis at BMC is high; with more resistance rates among ESBL compared to non ESBL isolates. There is a need for strengthen ESBL surveillance in this setting so as to guide specific therapy.
authors: Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania. senijj80@gmail.com.
authors: Jeremiah
authors: J
authors: Seni
authors: Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.
authors: Enock
authors: E
authors: Sweya
authors: Department of Surgery, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.|Department of Surgery, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania.
authors: Amri
authors: A
authors: Mabewa
authors: Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.
authors: Stephen E
authors: SE
authors: Mshana
authors: Department of Surgery, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.|Department of Surgery, Bugando Medical Centre, P.O. Box 1370, Mwanza, Tanzania.
authors: Japhet M
authors: JM
authors: Gilyoma
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004755:Enterobacteriaceae / Q000145:classification / Q000201:enzymology* / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000382:microbiology*; D015995:Prevalence; D013636:Tanzania / Q000453:epidemiology; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases
keywords: ESBL; Mwanza; Secondary peritonitis; Tanzania