Antimicrobial Susceptibility Patterns of Bacterial Isolates in Patients at Moi County Referral Hospital, Voi

Abstract

Background Antimicrobial resistance (AMR) is an increasing worldwide concern to global health. Infections caused by these resistant organisms increase morbidity, mortality and treatment costs. This study was conducted at Moi County Referral Hospital, Voi. The aim of this study was to bridge the knowledge gap in antimicrobial resistance in order to influence better patient management. The data available in the country mainly focuses on antimicrobial surveillance within the national referral hospitals and Nairobi County private facilities. This study focused on a government facility located in Taita-Taveta County that has been carrying out culture and sensitivity on both pus and urine samples. Objective The aim of this study was to identify bacterial isolates cultured from patient samples and their corresponding antimicrobial susceptibility patterns and to describe the WHO antibiotic resistant ‘priority pathogens’ identified in the study population. Methodology This was a retrospective study carried out at Moi County Referral Hospital, Voi. It involved a review of patient laboratory records for bacterial isolates cultured from pus and urine samples carried out in the years 2015-2018 and their antimicrobial susceptibility patterns. Information on the patient's age and sex, bacteria isolated, antimicrobial susceptibility, duration of admission and the patient outcome was extracted and entered into a data abstraction tool. Statistical analysis was done on IBM SPSS statistics software. Results A total of 1098 cultures were carried out in pus and urine samples from the years 2015-2018, 296 were positive. Isolates with complete records that were included in the study were 250, 46 of them were excluded due to missing data. The samples were obtained from both inpatients and outpatients. Pus samples were (176/250, 70.4%), urine samples were (74/250, 29.6%). Samples from the outpatient department were (197/250, 78.8%) and (53/250, 21.2%) from the inpatient department. Gram negative bacteria were predominantly isolated 149/250, 59.6% and gram positive bacteria were (101/250, 40.4%). The only gram positive isolate was S. aureus. Gram negative bacteria isolated included E. coli 28%, Klebsiella spp 16%, Pseudomonas spp 10%, and Proteus spp 6%. Resistance was observed with commonly used first-line antimicrobials such as penicillins, macrolides, sulfamethoxazole-trimethoprim and 3rd generation cephalosporins. Conclusion There’s a rising resistance to first-line antibiotics and noted emerging resistance to second line antimicrobials. This shows a need for antimicrobial surveillance and antibiotic stewardship in order to combat this rising surge in antimicrobial resistance