What is it about?

There is worldwide concern of rapidly increasing antimicrobial resistance (AMR). However, there is paucity of resistance surveillance data and updated antibiograms in Africa in general. This study was undertaken in Kenyatta National Hospital (KNH) -the largest public tertiary referral centre in East & Central Africa—to help bridge existing AMR knowledge and practice gaps.

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Why is it important?

Analysis of 624 isolates revealed AMR rates higher than most recent local and international reports. 88% of isolates tested were multi-drug resistant (MDR) whereas 26% were extensively- drug resistant (XDR). E. coli and K. pneumoniae had poor susceptibility to penicillins (8–48%), cephalosporins (16–43%), monobactams (17–29%), fluoroquinolones (22–44%) and trimethoprim-sulfamethoxazole (7%). Pseudomonas aeruginosa and Acinetobacter baumanii were resistant to penicillins and cephalosporins, with reduced susceptibility to carbapenems (70% and 27% respectively). S aureus had poor susceptibility to penicillins (3%) and trimethoprim-sulfamethoxazole (29%) but showed excellent susceptibility to imipenem (90%), vancomycin (97%) and linezolid (99%).

Perspectives

There was overwhelming resistance noted to commonly used antibiotics such as penicillins and cephalosporins. Rising resistance to potent antibiotics such as carbapenems posed a cause of concern. Collaborative efforts involving clinicians with other key stakeholders are needed to strengthen antimicrobial stewardship efforts, and promote regular surveillance and further research towards combating antimicrobial resistance for the present and future generations to come.

Frederick Wangai
University of Nairobi

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This page is a summary of: Bridging antimicrobial resistance knowledge gaps: The East African perspective on a global problem, PLoS ONE, February 2019, PLOS,
DOI: 10.1371/journal.pone.0212131.
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