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http://hdl.handle.net/1956/2266
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| Tittel: | Surveillance of antimicrobial resistance at a tertiary hospital in Tanzania |
| Forfattere: | Blomberg, Bjørn
Mwakagile, Davis S. M.
Urassa, Willy K.
Maselle, Samwel Y.
Mashurano, Marcellina
Digranes, Asbjørn
Harthug, Stig
Langeland, Nina |
| Dato: | 11-Oct-2004 |
| Forlag: | BioMed Central Ltd. |
| Serie/Rapport nr.: | BMC Public Health 4(45) |
| Sammendrag: | Background: Antimicrobial resistance is particularly harmful to infectious disease management in
low-income countries since expensive second-line drugs are not readily available. The objective of
this study was to implement and evaluate a computerized system for surveillance of antimicrobial
resistance at a tertiary hospital in Tanzania.
Methods: A computerized surveillance system for antimicrobial susceptibility (WHONET) was
implemented at the national referral hospital in Tanzania in 1998. The antimicrobial susceptibilities
of all clinical bacterial isolates received during an 18 months' period were recorded and analyzed.
Results: The surveillance system was successfully implemented at the hospital. This activity
increased the focus on antimicrobial resistance issues and on laboratory quality assurance issues.
The study identified specific nosocomial problems in the hospital and led to the initiation of other
prospective studies on prevalence and antimicrobial susceptibility of bacterial infections.
Furthermore, the study provided useful data on antimicrobial patterns in bacterial isolates from the
hospital. Gram-negative bacteria displayed high rates of resistance to common inexpensive
antibiotics such as ampicillin, tetracycline and trimethoprim-sulfamethoxazole, leaving
fluoroquinolones as the only reliable oral drugs against common Gram-negative bacilli. Gentamicin
and third generation cephalosporins remain useful for parenteral therapy.
Conclusion: The surveillance system is a low-cost tool to generate valuable information on
antimicrobial resistance, which can be used to prepare locally applicable recommendations on
antimicrobial use. The system pinpoints relevant nosocomial problems and can be used to
efficiently plan further research. The surveillance system also functions as a quality assurance tool,
bringing attention to methodological issues in identification and susceptibility testing. |
| URI: | http://dx.doi.org/10.1186/1471-2458-4-45
http://hdl.handle.net/1956/2266 |
| Vises i samlingene: | Centre for International Health
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