Antimicrobial Susceptibility Patterns of Bacterial Isolates at Tertiary Hospital in Tanzania: A Retrospective Cross-Sectional Study

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Kauke Bakari Zimbwe
Charity Alphonce Chiwambo
Yusto Julius Yona
Moshi Moshi Shabani
Alphonce Bilola Chandik
Humphrey Sawira Kiwelu
Reuben Mkala
Catherine Masalu
Henry Joseph
Witness Mchwampaka

Abstract

Background: Antimicrobial resistance (AMR) has escalated significantly within healthcare facilities and community settings, presenting substantial challenges in the management of bacterial infections. Our research aimed to analyze three-year trends in antimicrobial susceptibility through the evaluation of AMR patterns in blood, urine, and wound swabs.
Methods: A retrospective cross sectional study was carried out at The Benjamin Mkapa Tertiary Hospital (BMH) in Dodoma, Tanzania. Researchers reviewed electronic medical records and laboratory results of patients from January 2020 to December 2022.
Results: The number of positive blood samples tested for antimicrobial susceptibility testing (AST) was 166 (2020). Escherichia coli showed resistance trends to ceftriaxone 100 (60%), meropenem 19 (12%), amikacin 21 (12%), and piperacillin-tazobactam 17 (10%). Staphylococcus aureus exhibited resistance trends of 89 (46%) for ciprofloxacin and 75 (45%) for levofloxacin, while those for gentamicin, vancomycin, and azithromycin were 30 (18%), 18 (11%), and 58 (35%), respectively. ASTs were performed on 65 positive wound/pus swabs in 2020. Pseudomonas aeruginosa showed fluctuating resistance patterns to ciprofloxacin, meropenem, and piperacillin-tazobactam over the years: 7 (11%), 17 (26%), and 19 (29%) in 2020. In 2020, 107 urine samples were tested for AST. Escherichia coli showed resistance to nine antimicrobials, including ceftazidime 20 (19%), meropenem 7 (7%), piperacillin-tazobactam 7 (32%), cefuroxime 9 (8%), amoxicillin-clavulanic acid 29 (27%), nitrofurantoin 7 (7%), and amikacin 8 (8%).
Conclusion: The findings underscore an increase in antimicrobial resistance (AMR) among priority pathogens, emphasising the importance of evidence-based antibiotic selection for direct treatment, empiric therapy, and surgical prophylaxis. We recommend future prospective, ward-specific, and outpatient-inpatient comparative AMR surveillance to address existing limitations and improve infection management strategies.

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