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High Antimicrobial Resistance in ESKAPE Pathogens at a Rwandan Tertiary Hospital.

Charles Muhinda1,2, Gad Murenzi3, Leena Al-Hassan4

  • 1Department of Clinical Laboratory, Rwanda Military Referral and Teaching Hospital, Kigali P.O. Box 3377, Rwanda.

Pathogens (Basel, Switzerland)
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Summary

Antimicrobial resistance is a major threat. This study found high rates of resistance to common antibiotics among ESKAPE pathogens in Rwanda, emphasizing the need for better diagnostics and antibiotic stewardship.

Keywords:
ESKAPE pathogensRwandaantimicrobial resistanceclinical isolatesreferral hospital

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Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Global Health Security

Background:

  • Antimicrobial resistance (AMR) poses a significant global health challenge, leading to increased illness, death, and healthcare expenses.
  • ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter cloacae) are key drivers of hospital-acquired infections.
  • Limited data exists on AMR profiles of these critical pathogens in low-income regions.

Purpose of the Study:

  • To determine the prevalence and antimicrobial resistance patterns of ESKAPE pathogens.
  • To analyze resistance trends in clinical isolates from Rwanda Military Referral and Teaching Hospital.
  • To provide local data for informing public health strategies against AMR.

Main Methods:

  • A descriptive cross-sectional study was conducted from June 2022 to January 2023.
  • ESKAPE isolates were identified from clinical specimens using the BD Phoenix M50 System.
  • Antimicrobial susceptibility testing was performed, and data on sample type, ward, and demographics were analyzed.

Main Results:

  • Of 744 bacterial findings, 156 unique ESKAPE isolates were identified.
  • Klebsiella pneumoniae (41%) and Staphylococcus aureus (27%) were the most prevalent.
  • High resistance rates were observed: 63% of Gram-negatives resistant to third-generation cephalosporins, 32% to carbapenems. Acinetobacter baumannii showed 85% cephalosporin and 75% carbapenem resistance. Methicillin-resistant Staphylococcus aureus (MRSA) prevalence was 7%.

Conclusions:

  • This study represents the first hospital-based assessment of ESKAPE pathogens in Rwanda.
  • High levels of resistance to third-generation cephalosporins and carbapenems were detected.
  • Urgent strengthening of diagnostic capabilities and antimicrobial stewardship programs is recommended.