Bacteraemia in a Nigerian hospital: Implementing antimicrobial resistance surveillance.

IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Public Health in Africa Pub Date : 2025-02-07 eCollection Date: 2025-01-01 DOI:10.4102/jphia.v16i1.655

Adewale A Amupitan, Adeyemi T Adeyemo, Adefunke O Amupitan, Temitope O Obadare, Aaron O Aboderin

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引用次数: 0

Abstract

Background: Surveillance of drug-resistant infections is crucial for antimicrobial resistance (AMR) control. Implementing surveillance in low- and middle-income countries (LMICs) is challenging.

Aim: To investigate bacteraemia and describe AMR surveillance.

Setting: Tertiary healthcare facility.

Methods: Case finding was by WHO Global AMR and Use Surveillance System (GLASS). Blood samples were processed between May 2017 and June 2018, using BACTEC blood culture system. Bacterial identification, antibiotic susceptibility testing and detection of AMR genes followed standard protocols.

Results: Aerobic blood cultures were conducted in a third of clinical sepsis cases (n = 601/1851), of which 114 (19.0%) were true positives, with a 2.2% contamination rate. Pathogens recovered included six priority blood pathogens reportable to WHO GLASS. Sixteen (30.2%) of 53 Gram-negative isolates were extended-spectrum beta-lactamase producers, predominantly harbouring bla _CTX-M, three (5.7%) were AmpC beta-lactamase producers, and 20 (37.7%) were carbapenem-resistant, predominantly harbouring bla _KPC. Twenty-nine (50.9%) of 57 Staphylococcus aureus isolates were methicillin-resistant; 17 (58.6%) of these harboured mecA genes. Hospital-acquired infection (odds ratio [OR] = 0.3, 95% confidence interval [CI]=0.1-0.7, p = 0.004) was identified as a predisposing factor for the development of multidrug-resistant (MDR) bacteraemia. Bacteraemia with MDR organisms was significantly associated with mortality (OR = 3.8, 95% CI = 1.6-9.1, p = 0.001).

Conclusion: A wide variety of bacteria are responsible for bacteraemia in our setting, with more than half being multidrug-resistant. Bacteraemia with multidrug-resistant organisms was significantly associated with mortality, hence, the need for this AMR surveillance initiative.

Contribution: Implementing healthcare facility-based surveillance of AMR in LMICs is achievable despite limited microbiological laboratory capacity.

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来源期刊

Journal of Public Health in Africa PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

自引率

0.00%

发文量

审稿时长

10 weeks

期刊介绍： The Journal of Public Health in Africa (JPHiA) is a peer-reviewed, academic journal that focuses on health issues in the African continent. The journal editors seek high quality original articles on public health related issues, reviews, comments and more. The aim of the journal is to move public health discourse from the background to the forefront. The success of Africa’s struggle against disease depends on public health approaches.