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Increasing Antimicrobial Resistance in Surgical Wards at Mulago National Referral Hospital, Uganda, from 2014 to 2018—Cause for Concern?

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The African Center of Excellence in Bioinformatics and Data-Intensive Sciences, The Infectious Diseases Institute, Makerere University, Kampala P.O. Box 22418, Uganda
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Department of Immunology and Molecular Biology, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
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Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
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Strengthening Pharmaceutical Systems (SPS) Unit, Pharmacy Department, School of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
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Tuberculosis Research and Prevention Center NGO, Yerevan 0014, Armenia
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Academic Model Providing Access to Healthcare (AMPATH), P.O. Box 9505, Eldoret 30100, Kenya
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Research Capacity Strengthening, Special Programme for Research and Training in Tropical Diseases, 1201 Geneva, Switzerland
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Department of Dermatovenerology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar P.O. Box 1996, Ethiopia
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Amsterdam UMC, Academic Medical Centre, Department of Dermatology, Amsterdam Institute for Infection and Immunity (AI&I), University of Amsterdam, 1012 Amsterdam, The Netherlands
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Médecins Sans Frontières, Operational Centre Brussels, Operational Research Unit, 1617 Luxembourg, Luxembourg
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Department of Environmental Health Sciences, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
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Author to whom correspondence should be addressed.
Academic Editors: Olga Perovic, Tom Decroo, Chakaya Muhwa Jeremiah and John Frean
Trop. Med. Infect. Dis. 2021, 6(2), 82; https://doi.org/10.3390/tropicalmed6020082
Received: 22 March 2021 / Revised: 23 April 2021 / Accepted: 28 April 2021 / Published: 19 May 2021
(This article belongs to the Special Issue AMR in Low and Middle Income Countries)
Antimicrobial Resistance (AMR) and Healthcare Associated Infections (HAIs) are major global public health challenges in our time. This study provides a broader and updated overview of AMR trends in surgical wards of Mulago National Referral Hospital (MNRH) between 2014 and 2018. Laboratory data on the antimicrobial susceptibility profiles of bacterial isolates from 428 patient samples were available. The most common samples were as follows: tracheal aspirates (36.5%), pus swabs (28.0%), and blood (20.6%). Klebsiella (21.7%), Acinetobacter (17.5%), and Staphylococcus species (12.4%) were the most common isolates. The resistance patterns for different antimicrobials were: penicillins (40–100%), cephalosporins (30–100%), β-lactamase inhibitor combinations (70–100%), carbapenems (10–100%), polymyxin E (0–7%), aminoglycosides (50–100%), sulphonamides (80–100%), fluoroquinolones (40–70%), macrolides (40–100%), lincosamides (10–45%), phenicols (40–70%), nitrofurans (0–25%), and glycopeptide (0–20%). This study demonstrated a sustained increase in resistance among the most commonly used antibiotics in Uganda over the five-year study period. It implies ongoing hospital-based monitoring and surveillance of AMR patterns are needed to inform antibiotic prescribing, and to contribute to national and global AMR profiles. It also suggests continued emphasis on infection prevention and control practices (IPC), including antibiotic stewardship. Ultimately, laboratory capacity for timely bacteriological culture and sensitivity testing will provide a rational choice of antibiotics for HAI. View Full-Text
Keywords: antimicrobial resistance (AMR); trends; Structured Operational Research and Training IniTiative (SORT IT); surgical wards; Mulago National Referral Hospital (MNRH); Uganda antimicrobial resistance (AMR); trends; Structured Operational Research and Training IniTiative (SORT IT); surgical wards; Mulago National Referral Hospital (MNRH); Uganda
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MDPI and ACS Style

Mboowa, G.; Aruhomukama, D.; Sserwadda, I.; Kitutu, F.E.; Davtyan, H.; Owiti, P.; Kamau, E.M.; Enbiale, W.; Reid, A.; Bulafu, D.; Kisukye, J.; Lubwama, M.; Kajumbula, H. Increasing Antimicrobial Resistance in Surgical Wards at Mulago National Referral Hospital, Uganda, from 2014 to 2018—Cause for Concern? Trop. Med. Infect. Dis. 2021, 6, 82. https://doi.org/10.3390/tropicalmed6020082

AMA Style

Mboowa G, Aruhomukama D, Sserwadda I, Kitutu FE, Davtyan H, Owiti P, Kamau EM, Enbiale W, Reid A, Bulafu D, Kisukye J, Lubwama M, Kajumbula H. Increasing Antimicrobial Resistance in Surgical Wards at Mulago National Referral Hospital, Uganda, from 2014 to 2018—Cause for Concern? Tropical Medicine and Infectious Disease. 2021; 6(2):82. https://doi.org/10.3390/tropicalmed6020082

Chicago/Turabian Style

Mboowa, Gerald, Dickson Aruhomukama, Ivan Sserwadda, Freddy E. Kitutu, Hayk Davtyan, Philip Owiti, Edward M. Kamau, Wendemagegn Enbiale, Anthony Reid, Douglas Bulafu, Jeffrey Kisukye, Margaret Lubwama, and Henry Kajumbula. 2021. "Increasing Antimicrobial Resistance in Surgical Wards at Mulago National Referral Hospital, Uganda, from 2014 to 2018—Cause for Concern?" Tropical Medicine and Infectious Disease 6, no. 2: 82. https://doi.org/10.3390/tropicalmed6020082

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