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dc.contributor.authorChoonara, Faheema E.
dc.contributor.authorHaldorsen, Bjørg
dc.contributor.authorNdhlovu, Isaac
dc.contributor.authorSaulosi, Osborne
dc.contributor.authorMaida, Tarsizio
dc.contributor.authorLampiao, Fanuel
dc.contributor.authorSimonsen, Gunnar Skov
dc.contributor.authorEssack, Sabiha Y.
dc.contributor.authorSundsfjord, Arnfinn
dc.description.abstractBackground The aim of this prospective study was to ascertain antimicrobial resistance (AMR) in clinical bacterial pathogens from in-hospital adult patients at a tertiary hospital in Lilongwe, Malawi. Methods<p> <p>Clinical specimens (blood culture, pus, urine and cerebrospinal fluid) collected during June to December 2017 were examined for bacterial growth in standard aerobic conditions. One specimen per patient was included. Antimicrobial susceptibility testing (AST) was performed using the disk diffusion method and interpreted according to EUCAST guidelines. <p>Results A total of 694 specimens were collected during the study period, of which 336 (48%) specimen yielded visible bacterial growth. Of the 336 specimens, a total of 411 phenotypically different isolates were recovered. Of the 411 isolates, 84 isolates (20%) were excluded and the remaining 327 (80%) were further characterised. The characterised isolates were identified as ESKAPE pathogens (n=195/327; 60%), Escherichia coli (n=92/327; 28%), Proteus mirabilis (n=33/327; 10) or Salmonella spp. (n=7/327; 2%) and were included for further analysis. The excluded isolates (n=84) comprised of coagulase-negative staphylococci (n=25), streptococci (n=33), and low-prevalence Gram-negative bacilli (n=26). E. coli (n=92; 28%) and S. aureus (n=86; 26%) were the most dominant species. A multidrug resistant (MDR) extended spectrum β- lactamase (ESBL)-positive phenotype was detected in Klebsiella pneumoniae (n=20/29; 69%) and E. coli (n=49/92; 53%). One third of the Pseudomonas aeruginosa isolates were resistant to meropenem (MEM), but did not appear to be carbapenemase-producers. Methicillin resistant Staphylococcus aureus (MRSA) was molecularly confirmed in 10.5% of S. aureus (n=9/86). <p>Conclusion The high proportion of the MDR ESBL-phenotype in clinical isolates of Enterobacterales, strongly limits antimicrobial treatment options and has consequences for empirical and targeted antimicrobial treatment as well as clinical microbiology services and hospital infection control. There is need for a continuous surveillance and an antimicrobial stewardship (AMS) program to contain and prevent the spread of AMR.en_US
dc.identifier.citationChoonara, Haldorsen, Ndhlovu, Saulosi, Maida, Lampiao, Simonsen, Essack, Sundsfjord. Antimicrobial susceptibility profiles of clinically important bacterial pathogens at the Kamuzu Central Hospital in Lilongwe, Malawi. Malawi Medical Journal. 2022;34(1):9-16en_US
dc.identifier.cristinIDFRIDAID 2059248
dc.publisherUniversity of Malawi, College of Medicineen_US
dc.relation.journalMalawi Medical Journal
dc.rights.holderCopyright 2022 The Author(s)en_US
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)en_US
dc.titleAntimicrobial susceptibility profiles of clinically important bacterial pathogens at the Kamuzu Central Hospital in Lilongwe, Malawien_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US

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Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
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