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A review of antimicrobial resistance in East Africa

BACKGROUND AND OBJECTIVES: Knowledge 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 h...

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Autores principales: Ampaire, Lucas, Muhindo, Abraham, Orikiriza, Patrick, Mwanga-Amumpaire, Juliet, Bebell, Lisa, Boum, Yap
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AOSIS 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5436405/
https://www.ncbi.nlm.nih.gov/pubmed/28879114
http://dx.doi.org/10.4102/ajlm.v5i1.432
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author Ampaire, Lucas
Muhindo, Abraham
Orikiriza, Patrick
Mwanga-Amumpaire, Juliet
Bebell, Lisa
Boum, Yap
author_facet Ampaire, Lucas
Muhindo, Abraham
Orikiriza, Patrick
Mwanga-Amumpaire, Juliet
Bebell, Lisa
Boum, Yap
author_sort Ampaire, Lucas
collection PubMed
description BACKGROUND AND OBJECTIVES: Knowledge 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. METHOD: We 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. RESULTS: We 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%. CONCLUSION: Overall, 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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spelling pubmed-54364052017-09-06 A review of antimicrobial resistance in East Africa Ampaire, Lucas Muhindo, Abraham Orikiriza, Patrick Mwanga-Amumpaire, Juliet Bebell, Lisa Boum, Yap Afr J Lab Med Review Article BACKGROUND AND OBJECTIVES: Knowledge 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. METHOD: We 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. RESULTS: We 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%. CONCLUSION: Overall, 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. AOSIS 2016-09-15 /pmc/articles/PMC5436405/ /pubmed/28879114 http://dx.doi.org/10.4102/ajlm.v5i1.432 Text en © 2016. The Authors http://creativecommons.org/licenses/by/2.0/ Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.
spellingShingle Review Article
Ampaire, Lucas
Muhindo, Abraham
Orikiriza, Patrick
Mwanga-Amumpaire, Juliet
Bebell, Lisa
Boum, Yap
A review of antimicrobial resistance in East Africa
title A review of antimicrobial resistance in East Africa
title_full A review of antimicrobial resistance in East Africa
title_fullStr A review of antimicrobial resistance in East Africa
title_full_unstemmed A review of antimicrobial resistance in East Africa
title_short A review of antimicrobial resistance in East Africa
title_sort review of antimicrobial resistance in east africa
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5436405/
https://www.ncbi.nlm.nih.gov/pubmed/28879114
http://dx.doi.org/10.4102/ajlm.v5i1.432
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