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Antimicrobial Resistance Profile of Bacteria Causing Pediatric Infections at the University Teaching Hospital in
Jean Bosco Munyemana1,2, Bright Gatare3, Pauline Kabanyana4
1Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Insights
Pediatric bacterial infections show high antibiotic resistance in Rwanda, with ampicillin and amoxicillin-clavulanic acid being largely ineffective. This highlights the urgent need for antimicrobial stewardship and surveillance to combat rising resistance rates.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Antimicrobial Resistance
Background:
- Bacterial infections are a significant global health concern, particularly in children.
- Decreasing antimicrobial efficacy necessitates careful treatment strategies, especially empirical therapy in regions like Rwanda.
Purpose of the Study:
- To determine the antibiotic resistance patterns of common bacterial pathogens in pediatric patients in Rwanda.
- To inform empirical treatment guidelines and antimicrobial stewardship efforts.
Main Methods:
- Prospective study conducted from June 2018 to May 2019.
- Microbiological samples analyzed from 712 children with suspected bacterial infections.
- Antimicrobial sensitivity testing performed on 177 positive cultures.
Main Results:
- Key isolates included Klebsiella pneumoniae (28.2%), Escherichia coli (26.5%), and Staphylococcus aureus (21.4%).
- High resistance rates observed for ampicillin (86.2%), amoxicillin-clavulanic acid (82.4%), and amoxicillin (79%).
- Specific high resistance noted: K. pneumoniae to amoxicillin-clavulanic acid (100%), E. coli to tetracycline (91.7%) and ampicillin (90.6%).
Conclusions:
- A high prevalence of antimicrobial resistance to commonly prescribed antibiotics in pediatric patients was found.
- Findings underscore the need for caution in empirical antibiotic therapy and continuous monitoring of resistance trends.
- Effective agents like meropenem, vancomycin, nitrofurantoin, and ciprofloxacin showed better sensitivity against specific pathogens.
Abstract:
Bacterial infections pose a global threat, especially in the pediatric population. Antimicrobials that are used to treat such infections continuously show reduced efficacy, and empirical therapy is a major treatment option in Rwanda. This study aimed to determine the resistance rate of commonly used antibiotics in pediatric patients. The study was conducted from June 1, 2018 to May 30, 2019, and microbiological samples were collected from 712 children with suspected bacterial infections. Antimicrobial sensitivity testing was performed on 177 positive cultures (24%) that were considered for data analysis. The findings show that the major bacterial isolates were Klebsiella pneumoniae (n = 50, 28.2%), Escherichia coli (n = 47, 26.5%), and Staphylococcus aureus (n = 38, 21.4%). In general, the greatest antibiotic resistance rate was observed in ampicillin (n = 125, 86.2%), amoxicillin-clavulanic acid (n = 84, 82.4%), amoxicillin (n = 64, 79%), cefadroxil (n = 83, 69.2%), tetracycline (n = 72, 59.7%), ceftazidime (n = 42, 55.3%), and cefuroxime (n = 14, 53.8%). More specifically, Klebsiella pneumoniae was 100% resistant to amoxicillin-clavulanic acid, cefuroxime, trimethoprim-sulfamethoxazole, ceftazidime, erythromycin, and clindamycin. Staphylococcus aureus was 86.7% resistant to ampicillin, and Escherichia coli was 91.7% resistant to tetracycline, 90.6% resistant to ampicillin, 83.3% resistant to amoxicillin-clavulanic acid, 79.3% resistant to cefadroxil, and 78.6% resistant to ceftazidime. Moreover, Klebsiella pneumoniae from blood and urine was 96.8% and 100% sensitive, respectively, to meropenem. Staphylococcus aureus from blood was 100% sensitive to vancomycin, whereas Escherichia coli from urine was sensitive to clindamycin (100%), nitrofurantoin (80.6%), and ciprofloxacin (72.7%). In conclusion, our findings show a high resistance rate to commonly used antibiotics, which suggests precaution in empirical therapy and continued surveillance of antimicrobial resistance.
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