Prevalence of multiresistant gram-negative organisms in a tertiary hospital in Mwanza, Tanzania

A total of 800 clinical samples (urine, wound swab, pus, blood, aspirate, sputum etc) were processed over a period of 6 months. Gram-negative bacteria were identified using conventional in-house biochemical tests and susceptibility to common antibiotics done using disc diffusion methods. The disc approximation method was used to identify ESBL producers.A total of 377 Gram-negative bacteria (GNB) recovered from 377 clinical specimens were analyzed of which 76.9% were Enterobacteriaceae. Among all GNB, 110/377 (29.2%) were found to be ESBL producers. Species specific ESBLs rate among Klebsiella pneumoniae, Escherichia coli, Acinetobacter spp, Proteus spp and other enterobacteria were 63.7%, 24.4%, 17.7%, 6.4% and 27.9% respectively. A statistically significant higher number of inpatients 100/283 (35.3%) compared to 10/94 (10.6%) of outpatients had ESBL-producing organisms (p = 0.000023). Rates of resistances to gentamicin, tetracycline, sulphamethaxazole/trimethoprim and ciprofloxacin were significantly higher among ESBLs isolates than non-ESBL isolates (p = 0.000001).ESBL producing organisms are common at BMC (Bugando Medical Center) and pose a challenge to antibiotic therapy. Successful implementation of a routine detection of ESBL production is essential in designing appropriate antibiotic prescribing policies and infection control intervention programmes.Antimicrobial resistance among enteric Gram negative bacteria is fast becoming a global public health concern with rapid increase in multidrug resistant organisms [1]. Gram negative bacteria (GNB) are a common cause of urinary tract infections, neonatal sepsis and post surgical infections in hospitalized patients [1,2]. Resistance of Enterobacteriaceae to broad spectrum β-lactam antibiotics via ESBL production is an increasing problem worldwide [2].The prevalence of ESBL producing clinical isolates is more than 20% in Asia and South Africa [3]. ESBLs have been found in 30 to 60% of klebsiellae from intensive care