School of Biosecurity, Biotechnolgy and Laboratory Sciences (SBLS) Collection

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Browsing School of Biosecurity, Biotechnolgy and Laboratory Sciences (SBLS) Collection by Subject "Antibiotic resistance"
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    Knowledge, attitudes and practices about nosocomial infections and antibiotic susceptibility among Staphylococcus aureus isolated from surfaces in Nakasongola Military Hospital
    (Makerere University, 2023) Wasswa, Walugembe Emmanuel Kayiso
    Antibiotic resistance in nosocomial infection (NI) management is a major problem globally. The aim of this study was to assess the knowledge, attitudes, practices about nosocomial infections, antibiotic resistance and to determine the prevalence of tetM gene for tetracycline resistance in Staphylococcus aureus isolated from Nakasongola Military Hospital (NMH). A cross-sectional study design was employed and this involved two sub studies. The first one was the mixed field survey sub-study which was both qualitative and quantitative. It assessed the knowledge, attitudes and practices of Nakasongola Military Hospital health workers and patients about nosocomial infections prevention and control, their association with antimicrobial resistance (AMR) as well as antibiotic use. Structured questionnaires were used to collect general information from health workers (n꞊96) and patients (n꞊301), followed by key informant interviews to collect qualitative information from expert health workers (n꞊16) and observations to collect data basing on activities done at the hospital for 15 days. The second one was a laboratory-based sub-study which determined antibacterial resistance profiles on Staphylococcus aureus isolates from contact surfaces. Antibacterial resistance profiles against 13 antibiotics were performed using the Kirby-Bauer method. Genotypic studies were performed using conventional Polymerase Chain Reaction (PCR) to determine the presence of tetM gene among tetracycline resistant Staphylococcus aureus. Findings from the survey revealed that health workers generally had high (96.9%) knowledge, favorable (96.9%) attitudes and good (93.8%) practices whereas a few patients had high (7%) knowledge, favorable (24.9%) attitudes and good (19.6%) practices regarding NIs, AMR and antibiotic use. Observations revealed absence of regulations for visitors and lack of proper hygiene practices by visitors. Amoxicillin and Trimethoprim/ sulfamethazole were the most commonly (100%) prescribed antibiotics. Ampicillin, imipenem (2.8%), cefixime (11.3%) and ciprofloxacin (14.1%) showed the lowest bacterial resistance. Staphylococcus aureus showed high resistance against amoxycillin (85.9%), Trimethoprim/sulfamethazole (71.8%) and tetracycline (70.4%). About 78% of the hospital surfaces were contaminated by Staphylococcus aureus, 50/71 isolates exhibiting resistance against tetracycline; only (10%) harbored the tetM gene of resistance. The study recommends that NMH should emphasize sensitization of people about NIs and AMR. Cefixime and ciprofloxacin may be used as the best choice for empirical treatment at NMH. Further studies should be carried out to establish other markers for tetracycline resistance in Staphylococcus aureus.
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    Rapid detection and antibiotic resistance of Group B Streptococcus from women at Kawempe Hospital Kampala, Uganda
    (Makerere University, 2022) Nsimire, Juliet Sendagala
    An accurate and rapid bedside test undertaken in labour ward to detect Group B Streptococcus (GBS) maternal colonization has the potential to improve the effectiveness of intrapartum antibiotic prophylaxis prevention strategies, especially in countries like Uganda, where antenatal testing would not be practical. The study evaluated the diagnostic accuracy of the Hibergene LAMP (HG GBS) assay for GBS detection using Todd Hewitt (LIM) broth and direct swab samples in a cohort of Ugandan women. Antimicrobial resistance profiles of GBS isolates from the same cohort were also described. Rectal and vaginal swabs were collected from 647 pregnant women and 83 non-pregnant women attending Kawempe Hospital, Kampala Uganda. One set of the swabs were tested directly by HG GBS and the other set were sent to the Medical Research Council laboratories and inoculated in LIM and after 24hours of incubation, tested by HG GBS and culture using chromogenic agar. Samples with discordant results were re-tested using the Allplex Meningitis-B assay (Allplex) that targets the CAMP factor (cfb) gene of GBS. Antibiotic susceptibility was determined by the Kirby Bauer disc diffusion method following EUCAST guidelines. Data was analyzed using Stata version15 software. The sensitivity and specificity of the HG GBS assay using LIM were 98.64% (95% CI, 95.17% - 99.83%) and 78.92% (95% CI, 76.43%-81.26 respectively. For direct swab samples, the sensitivity and specificity were 91.11% (95% CI, 78.78% - 97.52%) and 77.69% (95% CI, 69.22% - 84.75%) respectively. There was 87% agreement between Allplex and HG GBS results. Out of 140 GBS isolates 2(1.43%) were resistant to penicillin G, 28(20%) to erythromycin, and 14(10%) to clindamycin and all isolates were susceptible to vancomycin. The HG GBS demonstrated a higher sensitivity compared to enrichment culture. Therefore, the assay could readily be used to screen women who are in labour for GBS rectovaginal colonization to guide IAP.