Trends, patterns and relationship of antimicrobial use and resistance in bacterial isolates tested between 2015-2020 in a national referral hospital of Zambia.

Autor: Shawa M; Hokudai Center for Zoonosis Control in Zambia, Hokkaido University, Lusaka, Zambia.; Division of Infection and Immunity, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan., Paudel A; Division of Infection and Immunity, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan.; GenEndeavor LLC, Hayward, CA, United States of America., Chambaro H; Central Veterinary Research Institute, Ministry of Fisheries and Livestock, Lusaka, Zambia., Kamboyi H; Division of Infection and Immunity, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan., Nakazwe R; Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia., Alutuli L; Department of Pharmacy, University Teaching Hospital, Lusaka, Zambia., Zorigt T; Division of Infection and Immunity, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan., Sinyawa T; Central Veterinary Research Institute, Ministry of Fisheries and Livestock, Lusaka, Zambia., Samutela M; Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia., Chizimu J; Zambia National Public Health Institute, Ministry of Health, Lusaka, Zambia., Simbotwe M; Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia., Hayashida K; Division of Collaboration and Education, International Institute for Zoonosis Control, Hokkaido University, Kita-ku, Sapporo, Japan., Nao N; Hokudai Center for Zoonosis Control in Zambia, Hokkaido University, Lusaka, Zambia.; Division of International Research Promotion, International Institute for Zoonosis Control, Hokkaido University, Kita-ku, Sapporo, Japan.; One Health Research Center, Hokkaido University, Kita-ku, Sapporo, Japan., Kajihara M; Hokudai Center for Zoonosis Control in Zambia, Hokkaido University, Lusaka, Zambia.; Division of International Research Promotion, International Institute for Zoonosis Control, Hokkaido University, Kita-ku, Sapporo, Japan., Furuta Y; Division of Infection and Immunity, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan.; Toyota Central R&D Labs., Inc., Nagakute, Japan., Suzuki Y; Division of Bioresources, International Institute for Zoonosis Control, Hokkaido University, Kita-ku, Sapporo, Japan.; International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, Kita-ku, Sapporo, Japan.; Institute for Vaccine Research and Development (HU-IVReD), Hokkaido University, Kita-ku, Sapporo, Japan., Sawa H; Hokudai Center for Zoonosis Control in Zambia, Hokkaido University, Lusaka, Zambia.; Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia.; Division of International Research Promotion, International Institute for Zoonosis Control, Hokkaido University, Kita-ku, Sapporo, Japan.; One Health Research Center, Hokkaido University, Kita-ku, Sapporo, Japan.; Division of Bioresources, International Institute for Zoonosis Control, Hokkaido University, Kita-ku, Sapporo, Japan.; International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, Kita-ku, Sapporo, Japan.; Institute for Vaccine Research and Development (HU-IVReD), Hokkaido University, Kita-ku, Sapporo, Japan.; Division of Molecular Pathobiology, International Institute for Zoonosis Control, Hokkaido University, Kita-ku, Sapporo, Japan., Hang'ombe B; Africa Centre of Excellence for Infectious Diseases of Humans and Animals, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia.; Department of Para-clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia., Higashi H; Division of Infection and Immunity, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Apr 16; Vol. 19 (4), pp. e0302053. Date of Electronic Publication: 2024 Apr 16 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0302053
Abstrakt: Increased antimicrobial resistance (AMR) among bacteria underscores the need to strengthen AMR surveillance and promote data-based prescribing. To evaluate trends and associations between antimicrobial usage (AMU) and AMR, we explored a dataset of 34,672 bacterial isolates collected between 2015 and 2020 from clinical samples at the University Teaching Hospital (UTH) in Lusaka, Zambia. The most frequently isolated species were Escherichia coli (4,986/34,672; 14.4%), Staphylococcus aureus (3,941/34,672; 11.4%), and Klebsiella pneumoniae (3,796/34,672; 10.9%). Of the 16 drugs (eight classes) tested, only amikacin and imipenem showed good (> 50%) antimicrobial activity against both E. coli and K. pneumoniae, while nitrofurantoin was effective only in E. coli. Furthermore, 38.8% (1,934/4,980) of E. coli and 52.4% (2,079/3,791) of K. pneumoniae isolates displayed multidrug resistance (MDR) patterns on antimicrobial susceptibility tests. Among S. aureus isolates, 44.6% (973/2,181) were classified as methicillin-resistant (MRSA). Notably, all the MRSA exhibited MDR patterns. The annual hospital AMR rates varied over time, while there was a weak positive relationship (r = 0.38, 95% CI = 0.11-0.60) between the monthly use of third-generation cephalosporins (3GCs) and 3GC resistance among Enterobacterales. Overall, the results revealed high AMR rates that fluctuated over time, with a weak positive relationship between 3GC use and resistance. To our knowledge, this is the first report to evaluate the association between AMU and AMR in Zambia. Our results highlight the need to strengthen antimicrobial stewardship programs and optimize AMU in hospital settings.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Shawa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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