Prevalence, trend and antimicrobial susceptibility of Methicillin Resistant Staphylococcus aureus in Nigeria: a systematic review

Abubakar, Usman; Sulaiman, Syed Azhar Syed

doi:10.1016/j.jiph.2018.05.013

Cited by 53 publications

(47 citation statements)

References 20 publications

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“…Although, this was lower than the rate reported in Europe (about 40%) [6], the use of third generation cephalosporin and fluoroquinolone use in Nigeria needs to be monitored because these classes of antibiotic increase the risk of Clostridium difficile infection [22] and the emergence and spread of extended spectrum beta-lactamase (ESBL) infections [23]. The excessive use of fluoroquinolone among hospitalized patients could explain the high rate of resistance to the antibiotics among clinical isolates in Nigeria [24]. Therefore, antimicrobial stewardship intervention is required to promote appropriate use of broad spectrum antibiotics in the hospital setting.…”

Section: Discussionmentioning

confidence: 93%

Antibiotic use among hospitalized patients in northern Nigeria: a multicenter point-prevalence survey

Abubakar

2020

BMC Infect Dis

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Background: The evaluation of antibiotic use among hospitalized patients is a primary step required to design antibiotic stewardship intervention. There is paucity of data describing antibiotic use in hospitals across Northern Nigeria. This study evaluates the prevalence and indications for antibiotic use among inpatients in three acute care hospitals. Methods: A point-prevalence survey was conducted among patients in the wards before or at 8.00 a.m. on the day of the survey, using the point-prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals protocol. The survey was conducted between April and May 2019. The medical records of the patients were reviewed by a clinical pharmacist with the support of physicians and nurses.Results: Overall, 80.1% (257/321) of the patients used at least one antibiotic on the day of the survey. The prevalence of antibiotic use ranged from 72.9% in obstetrics and gynecology to 94.6% in pediatric medical specialty. Community acquired infections (38.7%) and surgical antibiotic prophylaxis (22.5%) were the most common indications. Surgical antibiotic prophylaxis was used or scheduled to be used for more than a day in all the cases. Metronidazole (30.5%), ciprofloxacin (17.1%), ceftriaxone (16.8%), amoxicillin-clavulanate (12.5%) and gentamicin (11.8%) were the most commonly prescribed antibiotics. Overall, broad spectrum antibiotics represented one-third of all the prescriptions. The change of initial antibiotic prescription was reported in one-third of the patients and the reasons include a switch to oral antibiotic (28.5%), escalation (4.5%) and de-escalation (3.6%). Of the 257 patients with an antibiotic prescription, 6.2% had redundant antibiotic combinations. Conclusion:The prevalence of antibiotic use was high with one in three prescriptions having a broad spectrum antibiotic. Prolonged use of surgical antibiotic prophylaxis and redundant antibiotic combination were observed. Antimicrobial stewardship interventions are recommended in order to reduce the use of antibiotics and promote appropriate antibiotics prescribing.

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Section: Discussionmentioning

confidence: 93%

Antibiotic use among hospitalized patients in northern Nigeria: a multicenter point-prevalence survey

Abubakar

2020

BMC Infect Dis

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“…A study on S. aureus isolates indicates that there are some genotypes and virulence factors that are widespread in Africa due to staphylococcal infection than from colonization; e.g. PVL encoded by the lukS-pv and lukF-pv genes [31].…”

Section: Pathogenicity and Virulencementioning

confidence: 99%

“…A common feature in staphylococcal research in Africa is the high level of resistance to penicillin among other antimicrobial agents; this is encoded by the blaZ gene [31]. According to a study by Alem et al, all the S. aureus and CoNS isolates obtained showed resistance to penicillin, oxacillin, ampicillin, and chloramphenicol.…”

Section: Antimicrobial Resistancementioning

confidence: 99%

Staphylococcus aureus and Coagulase-Negative Staphylococci in Bacteraemia: The Epidemiology, Predisposing Factors, Pathogenicity and Antimicrobial Resistance

Grace¹,

Olayinka²,

Onaolapo³

et al. 2019

Clin Microbiol

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Staphylococcus species are the predominant Gram-positive organisms obtained from blood culture samples. Its incidence in bloodstream infection among children and adults varies among. Staphylococcus aureus is regarded as pathogenic with high morbidity and mortality while coagulase-negative staphylococci (CoNS) are often regarded as a contaminant and not a true cause of bacteremia despite its rising occurrence. Predisposing factors of staphylococcal bacteremia include malnutrition, malaria, HIV/AIDS and nosocomial infections. Methicillin-resistance in Staphylococcus aureus and CoNS in bacteremia is associated with an increase in multidrug-resistant virulent strains when compared to methicillin-sensitive S. aureus or CoNS. The impact of coagulase-negative staphylococci in bacteremia is on the increase with marked clinical complications. However, this review summarizes the prevalence and epidemiology of S. aureus and CoNS in bacteremia based on research outcomes in Africa, Asia, Europe, and North America.

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“…In Nigeria, the inappropriate use of antibiotics in both hospital and community settings has been previously reported [6][7][8]. In addition, the prevalence of antibiotic resistance has increased in recent years [9]. Non-prescription dispensing and self-medication with antibiotics are common issues in Nigeria.…”

Section: Introductionmentioning

confidence: 99%

Practices and Perception of Nigerian Community Pharmacists Towards Antimicrobial Stewardship Program

Abubakar

2020

Int J Pharm Pharm Sci

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Objective: Community pharmacists have an important role in promoting the appropriate use of antibiotics. There is a paucity of data describing the contributions of community pharmacists in antimicrobial stewardship program (ASP) in Nigeria. This study evaluated the practices and perceptions of community pharmacists towards ASP. Methods: This was a cross-sectional study conducted among community pharmacists in two cities in Northern Nigeria: Minna and Kaduna, using a 30-item validated and pre-tested questionnaire. Data collected between April and May 2019 and analyzed using SPSS version 23. Results: Of 130 community pharmacists, 98 completed and returned the questionnaire (response rate: 75.3%). More than 90% strongly agreed/agreed that ASP is important to reduce inappropriate use of antibiotics and antibiotic resistance, improve patient’s clinical outcomes. However, lack of training (56.1%), lack of cooperation from physicians (61.2%) and lack of access to patient records (66.8%) were identified as barriers to community pharmacists’ involvement in ASP. Overall, community pharmacists had good practices (median score: 3.5; IQR: 1–5) and positive perceptions (median score: 4.0; IQR: 3–5) towards ASP. Job status and dispensing antibiotics without prescription were significantly associated with practice, while age and job status were associated with perception towards ASP. Conclusion: Community pharmacists demonstrated good practices and positive perceptions towards ASP. However, lack of training and lack of cooperation from prescribers limit their involvement in the program. Training of community pharmacists in antimicrobial stewardship and inter-professional collaboration are recommended.

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Prevalence, trend and antimicrobial susceptibility of Methicillin Resistant Staphylococcus aureus in Nigeria: a systematic review

Cited by 53 publications

References 20 publications

Antibiotic use among hospitalized patients in northern Nigeria: a multicenter point-prevalence survey

Antibiotic use among hospitalized patients in northern Nigeria: a multicenter point-prevalence survey

Staphylococcus aureus and Coagulase-Negative Staphylococci in Bacteraemia: The Epidemiology, Predisposing Factors, Pathogenicity and Antimicrobial Resistance

Practices and Perception of Nigerian Community Pharmacists Towards Antimicrobial Stewardship Program

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