Clindamycin Resistance among Staphylococcus Aureus Isolated at Mbarara Regional Referral Hospital, in South Western Uganda

Mwambi, Bashir; Iramiot, Jacob Stanley; Bwanga, Freddie; Nakaye, Marthae; Itabangi, Herbert; Bazira, Joel

doi:10.9734/bmrj/2014/10572

Cited by 9 publications

(14 citation statements)

References 17 publications

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“…In a multivariate analysis, inducible CLI resistance and cancer were identified as independent predictors of MRSA‐SSI . In a similar study, out of 300 clinical S. aureus isolates, 22 were resistant to VAN, 187 were SXT‐resistant, and 143 were resistant to ERY …”

Section: Resultsmentioning

confidence: 88%

Molecular epidemiology and mechanisms of antibiotic resistance inEnterococcusspp.,Staphylococcusspp., andStreptococcusspp. in Africa: a systematic review from a One Health perspective

Sekyere

Mensah

2019

Annals of the New York Academy of Sciences

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A systematic review of antibiotic‐resistant Gram‐positive bacteria in Africa from a One Health perspective is lacking. Here, we report result from a search for English‐language articles on the resistance mechanisms and clonality of Gram‐positive bacteria in Africa between 2007 and 2019 reported in PubMed, Web of Science, ScienceDirect, and African Journals OnLine; 172 studies from 22 different African countries were identified. Resistance genes, such as mecA, erm(B), erm(C), tet(M), tet(K), tet(L), vanB, vanA, vanC, and tet(O), were found to be common. Staphylococcus spp., Enterococcus spp., and Streptococcus spp. were the main species reported by the studies, with clones such as Staphylococcus aureus ST5 (n = 218 isolates), ST8 (n = 127 isolates), ST80 (n = 133 isolates), and ST88 (n = 117 isolates), and mobile genetic elements such as IS16 (n = 28 isolates), IS256 (n = 96), Tn916 (n = 107 isolates), and SCCmec (n = 4437 isolates) identified. SCCmec IV (n = 747 isolates) was predominant, followed by SCCmec III (n = 305 isolates), SCCmec II (n = 163 isolates), SCCmec V (n = 135 isolates), and SCCmec I (n = 79 isolates). Resistance to penicillin (n = 5926 isolates), tetracycline (n = 5300 isolates), erythromycin (n = 5151 isolates), rifampicin (n = 3823 isolates), gentamycin (n = 3494 isolates), sulfamethoxazole/trimethoprim (n = 3089 isolates), and ciprofloxacin (n = 2746 isolates) was common in most reports from 22 countries. Clonal dissemination of resistance across countries and between humans, animals, and the environment was observed. Resistance rates ranged from 1.4% to 100% for 15 of the studies; 10 were One Health–related studies. Strict infection control measures, antimicrobial stewardship, and periodic One Health epidemiological surveillance studies are needed to monitor and contain the threat of increasing antibiotic resistance in Africa.

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Section: Resultsmentioning

confidence: 88%

Molecular epidemiology and mechanisms of antibiotic resistance inEnterococcusspp.,Staphylococcusspp., andStreptococcusspp. in Africa: a systematic review from a One Health perspective

Sekyere

Mensah

2019

Annals of the New York Academy of Sciences

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“…Of the 34 full-text articles available, 22 were excluded, because the data presented were from non-East African countries that were inseparable from data presented about East African countries ( n = 5) or their laboratory methods were not well defined ( n = 17) ( Figure 1 ). The remaining 12 articles were included in this review, six describing AMR patterns in Uganda, 10 , 11 , 12 , 13 , 14 , 15 five in Ethiopia 16 , 17 , 18 , 19 , 20 and one in Tanzania 21 ( Table 1 ). Neither studies from Rwanda nor studies from the Democratic Republic of the Congo met inclusion criteria for this review.…”

Section: Resultsmentioning

confidence: 99%

“…In this study, S. aureus also showed significant resistance to trimethoprim-sulfamethoxazole (62%) and oxacilin (36%), with a demonstrated prevalence of MRSA equal to 36%. 12 Resistance to vancomycin, one of the last-line drugs for treating MRSA, was also found (7.3%). 12 …”

Section: Resultsmentioning

confidence: 99%

A review of antimicrobial resistance in East Africa

et al. 2016

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Background and objectivesKnowledge of local and regional antimicrobial resistance (AMR) is important for clinical decision making. However, surveillance capacity for AMR is lacking throughout East Africa, and current AMR data are sparse. We sought to address this gap by summarising all available high-quality data on AMR in the East Africa region.MethodWe searched the PubMed database and African Journals Online archives in April and May 2015 using the search term ‘antimicrobial resistance AND sub-Saharan Africa’ to find articles published from 2005 onwards. Only full-text articles in English were included.ResultsWe included 12 published articles in our analysis. Most articles were on bloodstream infections, hospital-based and cross-sectional in design; a majority described either community- or hospital-acquired infections. High levels of AMR to commonly-used antibiotics were reported, including 50% – 100% resistance to ampicillin and cotrimoxazole infections, emerging resistance to gentamicin (20% – 47%) and relatively high levels of resistance to ceftriaxone (46% – 69%) among Gram-negative infections. Much of the resistance was reported to be in Klebsiella species and Escherichia coli. Among Gram-positive infections, extensive resistance was reported to ampicillin (100%), gentamicin and ceftriaxone (50% – 100%), with methicillin-resistant Staphylococcus aureus prevalence ranging from 2.6% – 4.0%.ConclusionOverall, bacterial resistance was reported among commonly-used antibiotics (ampicillin, gentamicin and ceftriaxone), raising concern that these antibiotics may no longer be useful for treating moderate or severe bacterial infections in East Africa. Thus, empirical treatment of bacterial infections needs to be reconsidered and guided by local assessment of AMR. Improvements in the limited amount of quality data and lack of harmonisation in assessing the burden of AMR are also needed.

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“…Among the MRSA strains identi ed, 45.5% (23/50) and 2% (1/50) phenotypically co-expressed inducible clindamycin resistance (MLS B resistance marker) and vancomycin resistance respectively. A study by Mwanbi et al conducted in Uganda on clinical isolates reported a closely similar prevalence rate (36%) of clindamycin resistance (33). Resistance to clindamycin would have been due to an increased use of the drug for patient management in the region.…”

Section: Mrsa Carriage Prevalence and Associated Carriage Risk Factorsmentioning

confidence: 87%

Methicillin Resistant Staphylococcus aureus nasal carriage and associated factors in a rural tertiary hospital in Eastern Uganda: A prospective cross-sectional study

Thembo

Masifa

Kamugisha

et al. 2020

Preprint

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Background: Asymptomatic carriage of Methicillin-Resistant Staphylococcus aureus (MRSA) can predispose the host to a wide array of infections that can be difficult to treat due to antibiotic resistance. To inform public health strategies, the study sought to describe MRSA nasal carriage frequencies and the associated factors concerning nasal carriage among patients attending Mbale Regional Referral Hospital (MRRH). Methods: Nasal swabs were obtained from consented (aged >15years) participants presenting to the hospital for medical care between January and April 2018 [L1] . Direct Culture of swabs was performed on blood agar and then incubated at 37℃ for 24 hours. Identification of S. aureus was done using conventional biochemical tests. Phenotypic screening and confirmation of MRSA was done using cefoxitin disc (30µg) test and MICs on the Phoenix M50 instrument respectively. Patient demographic characteristics and the MRSA nasal carriage risk factors were collected using a pre-tested questionnaire. Results: Overall, majority of the participants were in-patients (138, 63.3%) with the proportions of both females and males among the participants being 154/218 (70.6%) and 64/218 (29.3%) respectively. Mean age for both female and male participants was 40.16 (SD± 17.04) years respectively. S . aureus nasal carriage rate among the participants was 22.9% (50/218), with 57.9% (29/50) of the harboured strains phenotypically expressing methicillin resistance ( mecA mediated). Phenotypic co-expression with i nducible clindamycin resistance and vancomycin resistance was displayed in 45.5% (23/50) and 2% (1/50) of the studied isolates respectively. Colonisation with MRSA did not show any significant relationship with all the studied factors. Conclusion : There was a moderate S. aureus nasal carriage among the participants in Mbale Regional Referral Hospital with a highly noted phenotypic expression of methicillin resistance among the isolated S. aureus strains. The studied factors were not significantly associated with the rate of MRSA nasal carriage. For surveillance purposes to combat future outbreaks, there is a need to do a larger study to better draw generalizable conclusions of carriage in the population. [L1] This is an important statement. I suggest that we reinstatate it if we are still in recommended word count

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Clindamycin Resistance among Staphylococcus Aureus Isolated at Mbarara Regional Referral Hospital, in South Western Uganda

Cited by 9 publications

References 17 publications

Molecular epidemiology and mechanisms of antibiotic resistance inEnterococcusspp.,Staphylococcusspp., andStreptococcusspp. in Africa: a systematic review from a One Health perspective

Molecular epidemiology and mechanisms of antibiotic resistance inEnterococcusspp.,Staphylococcusspp., andStreptococcusspp. in Africa: a systematic review from a One Health perspective

A review of antimicrobial resistance in East Africa

Methicillin Resistant Staphylococcus aureus nasal carriage and associated factors in a rural tertiary hospital in Eastern Uganda: A prospective cross-sectional study

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