The epidemiology of antibiotic-resistant clinical pathogens in Uganda

Dados Bibliográficos

ID19550832
AutoresRitah Namusoosa (0009-0001-2743-965X, Ministry of Health), Ibrahim Mugerwa (0000-0003-4462-2867, Ministry of Health), Keneth Iceland Kasozi (0000-0002-5763-7964, Kabale University), Allan Muruta (0009-0006-1353-8389, Ministry of Health), Grace Najjuka (0000-0001-6689-1502, Ministry of Health), Winifred D Atuhaire (Ministry of Health), Susan Nabadda (0000-0003-2357-2530, Ministry of Health), Henry Mwebesa (Ministry of Health), Charles Olaro (0000-0001-8731-7227, Ministry of Health), Isaac Ssewanyana (0000-0001-8605-2001, Ministry of Health), Aloysious Ssemaganda (0000-0003-4705-7912, Ministry of Health), Adrian Muwonge (0000-0002-8579-0384, Roslin Institute, autor correspondente)
Ano2024
Volume14
Páginas04184-04184
Data de publicação2024-08-30
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoJournal of Global Health (JOURNAL)
Identificadores do periódicoISSN: 2047-2978 • E-ISSN: 2047-2986
EditoraInternational Society of Global Health (PUBLISHER • GB)
DOI10.7189/jogh.14.04184
PMID39212655
OpenAlexW4402055630
IdiomaEN
Referências citadas36

Background: Antibiotic resistance (ABR) is a global challenge, and its control depends on robust evidence primarily derived from surveillance systems. Methods: We utilised a national surveillance data set to demonstrate how such evidence can be systematically generated. In doing so, we characterised the ABR profiles of priority clinical pathogens, identified associated factors, and drew inferences on antibiotic usage in Uganda. Results: Of the 12 262 samples collected between 2019-21, we analysed 9033 with complete metadata. ABR was steadily increasing at a rate of 0.5% per year, with a surge in 2021 and the highest and lowest levels of penicillin and carbapenems detected in the northern (odds ratio (OR) = 2.26; P < 0.001) and the northeast (OR = 0.28; P < 0.001) regions of Uganda respectively. ABR was commonly observed with Escherichia coli (OR = 1.18; P < 0.001) and Klebsiella pneumoniae (OR = 1.25; P < 0.001) among older and male patients (61-70 years old) (OR = 1.88; P = 0.005). Multi-drug resistance (MDR) and ABR were disproportionately higher among bloodstream infections than respiratory tract infections and urinary tract infections, often caused by Acinetobacter baumannii. Co-occurrence of ABR suggests that cephalosporins such as ceftriaxone are in high use all over Uganda. Conclusions: ABR is indeed a silent pandemic, and our results suggest it is increasing at 0.5% per year, with a notable surge in 2021 likely due to coronavirus disease 2019 (COVID-19). Of concern, ABR and MDR are mainly associated with bloodstream and surgical wound infections, with a gender and age dimension. However, it is encouraging that carbapenem resistance remains relatively low. Such evidence is critical for contextualising the implementation and evaluation of national action plans

Antibiotic resistance · Antibiotics · Biology · Environmental health · Antibiotic Resistance in Bacteria · Antibiotic Use and Resistance · Medicine · Urinary Tract Infections Management · Epidemiology · Internal Medicine · Microbiology · Virology