Wounds, Antimicrobial Resistance and Challenges of Implementing a Surveillance System in Myanmar: A Mixed-Methods Study
| Autor: | Myint-Myint Sein, Saw Saw, Bienvenu Salim Camara, Ajay M. V. Kumar, Win-Pa Sandar |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty 030106 microbiology GLASS medicine.disease_cause Article antimicrobials AMR surveillance 03 medical and health sciences 0302 clinical medicine Antibiotic resistance Internal medicine Ampicillin Medicine 030212 general & internal medicine General hospital General Immunology and Microbiology business.industry Pseudomonas aeruginosa Technician Public Health Environmental and Occupational Health operational research Antimicrobial Penicillin Infectious Diseases Staphylococcus aureus SORT IT wound infection business medicine.drug |
| Zdroj: | Tropical Medicine and Infectious Disease, Vol 6, Iss 80, p 80 (2021) Tropical Medicine and Infectious Disease Volume 6 Issue 2 |
| ISSN: | 2414-6366 |
| Popis: | Wound infections with drug-resistant bacteria lead to higher mortality and morbidity and increased healthcare costs. We aimed to describe the spectrum of bacterial pathogens, isolated from wound cultures in Yangon General Hospital in 2018, and their antimicrobial resistance (AMR) patterns and to understand the challenges in implementing an AMR surveillance system in Myanmar. We conducted a concurrent mixed-methods study involving analysis of surveillance data and in-depth interviews with nine key personnel involved in AMR surveillance. Of 1418 wound specimens processed, 822 (58%) were culture-positive. The most common Gram-positive bacteria were coagulase-negative staphylococci (23.3%) and Staphylococcus aureus (15.1%). Among Gram-negative bacteria, Escherichia coli (12.5%) and Pseudomonas aeruginosa (10.1%) were common. Staphylococcus aureus isolates were resistant to penicillin (98%), oxacillin (70%) and tetracycline (66%). Escherichia coli showed resistance to ampicillin (98%). Lack of dedicated and trained staff (microbiologist, technician, data entry operator), lack of computers at sentinel sites and non-uniform and non-standardized data capture formats were the major challenges in implementing AMR surveillance. These challenges need to be addressed urgently. We also recommend periodic analysis and sharing of antibiograms at every hospital to inform the treatment regimens used in wound management. |
| Databáze: | OpenAIRE |
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