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Trends in antimicrobial resistance in bloodstream infection isolates at a large urban hospital in Malawi (1998-2016): a surveillance study
- Source :
- Musicha, P, Cornick, J E, Bar-Zeev, N, French, N, Masesa, C, Denis, B, Kennedy, N, Mallewa, J, Gordon, M A, Msefula, C L, Heyderman, R S, Everett, D B & Feasey, N A 2017, ' Trends in antimicrobial resistance in bloodstream infection isolates at a large urban hospital in Malawi (1998-2016) : a surveillance study ', The Lancet Infectious Diseases, vol. 17, no. 10, pp. 1042-1052 . https://doi.org/10.1016/S1473-3099(17)30394-8, Musicha, P, Cornick, J E, Bar-Zeev, N, French, N, Masesa, C, Denis, B, Kennedy, N, Mallewa, J, Gordon, M A, Msefula, C L, Heyderman, P R S, Everett, D B & Feasey, D N A 2017, ' Trends in antimicrobial resistance in bloodstream infection isolates at a large urban hospital in Malawi (1998-2016) a surveillance study ', The Lancet Infectious Diseases, vol. 17, no. 10 . https://doi.org/10.1016/S1473-3099(17)30394-8, The Lancet. Infectious Diseases, LANCET INFECTIOUS DISEASES
- Publication Year :
- 2017
- Publisher :
- Elsevier, 2017.
-
Abstract
- BACKGROUNDBacterial bloodstream infection is a common cause of morbidity and mortality in sub-Saharan Africa, yet few facilities are able to maintain long-term surveillance. The Malawi-Liverpool-Wellcome Trust Clinical Research Programme has done sentinel surveillance of bacteraemia since 1998. We report long-term trends in bloodstream infection and antimicrobial resistance from this surveillance.METHODS In this surveillance study, we analysed blood cultures that were routinely taken from adult and paediatric patients with fever or suspicion of sepsis admitted to Queen Elizabeth Central Hospital, Blantyre, Malawi from 1998 to 2016. The hospital served an urban population of 920 000 in 2016, with 1000 beds, although occupancy often exceeds capacity. The hospital admits about 10 000 adults and 30 000 children each year. Antimicrobial susceptibility tests were done by the disc diffusion method according to British Society of Antimicrobial Chemotherapy guidelines. We used the Cochran-Armitage test for trend to examine trends in rates of antimicrobial resistance, and negative binomial regression to examine trends in icidence of bloodstream infection over time.FINDINGSBetween Jan 1, 1998, and Dec 31, 2016, we isolated 29 183 pathogens from 194 539 blood cultures. Pathogen detection decreased significantly from 327·1/100 000 in 1998 to 120·2/100 000 in 2016 (pINTERPRETATIONThe rapid expansion of ESBL and fluoroquinolone resistance among common Gram-negative pathogens, and the emergence of MRSA, highlight the growing challenge of bloodstream infections that are effectively impossible to treat in this resource-limited setting.FUNDINGWellcome Trust, H3ABionet, Southern Africa Consortium for Research Excellence (SACORE).
- Subjects :
- Adult
0301 basic medicine
Malawi
medicine.medical_specialty
Time Factors
Klebsiella pneumoniae
030106 microbiology
Population
wh_120
Bacteremia
Drug resistance
Microbiology
wc_200
03 medical and health sciences
Antibiotic resistance
Sepsis
Internal medicine
Drug Resistance, Bacterial
Antimicrobial chemotherapy
Journal Article
medicine
Humans
Child
education
Retrospective Studies
education.field_of_study
wa_30
Bacteria
biology
business.industry
Incidence
Articles
biology.organism_classification
medicine.disease
Hospitals
Anti-Bacterial Agents
3. Good health
Ciprofloxacin
Penicillin
Infectious Diseases
Population Surveillance
business
qy_450
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 14733099
- Database :
- OpenAIRE
- Journal :
- Musicha, P, Cornick, J E, Bar-Zeev, N, French, N, Masesa, C, Denis, B, Kennedy, N, Mallewa, J, Gordon, M A, Msefula, C L, Heyderman, R S, Everett, D B & Feasey, N A 2017, ' Trends in antimicrobial resistance in bloodstream infection isolates at a large urban hospital in Malawi (1998-2016) : a surveillance study ', The Lancet Infectious Diseases, vol. 17, no. 10, pp. 1042-1052 . https://doi.org/10.1016/S1473-3099(17)30394-8, Musicha, P, Cornick, J E, Bar-Zeev, N, French, N, Masesa, C, Denis, B, Kennedy, N, Mallewa, J, Gordon, M A, Msefula, C L, Heyderman, P R S, Everett, D B & Feasey, D N A 2017, ' Trends in antimicrobial resistance in bloodstream infection isolates at a large urban hospital in Malawi (1998-2016) a surveillance study ', The Lancet Infectious Diseases, vol. 17, no. 10 . https://doi.org/10.1016/S1473-3099(17)30394-8, The Lancet. Infectious Diseases, LANCET INFECTIOUS DISEASES
- Accession number :
- edsair.doi.dedup.....bf7789990b325d081d289c071471023a