Multidrug-Resistant Bacteria Among Culture Isolates at University of Gondar, Specialized Referral Hospital, Northwest Ethiopia: a Five-Year Retrospective Study.

BACKGROUND

Updated information on multidrug-resistant bacteria is essential because multidrug-resistant bacteria are one of the most important current threats to public health and prevalence of multidrug-resistant bacteria varies from time to time. A large number of people die annually due to infections caused by multidrug-resistant pathogens, with millions more suffering from serious infectious complications. The aim of this study was to determine the rate of multidrug-resistant bacteria isolates among culture requested patients at University of Gondar Specialized Referral Hospital, Northwest Ethiopia.

METHODS

A hospital-based retrospective cross-sectional study was conducted on all culture-positive patients' results at University of Gondar Specialized Referral Hospital, Northwest Ethiopia.

RESULTS

Of the 2,161 bacterial isolates, the overall prevalence of multidrug-resistant bacteria was 40.5% (876/ 2,161). The multidrug-resistance rate of Gram-negative bacteria was 52.4% (493/942) and Gram-positive bacteria was 31.4% (383/1,219). From all isolates, 22.3% (481/2,161) were from wound discharge followed by 19.57% (428/ 2,161) from blood and 18.14% (224/2,161) from urine. The predominant bacteria isolated were S. aureus (44.1% (952/2,161)) followed by E. coli (16.6% (359/2,161)), Klebsiella species (13.2% (179/2,161)), and Citrobacter (4% (86/2,161)). The isolates showed high levels of resistance to ampicillin (81.99% (692/844)), cotrimoxazole (66.62% (531/797)), and penicillin (62.66% (381/608)) and lower resistance to vancomycin (6.79% (46/677)), amikacin (20% (18/95)), and nitrofurantoin (20.90% (21/110)). Primary MDR isolates were Serratia species (83.3% (5/6)), Enterobacter species (66.7% (20/30)), Klebsiella pneumonia (65.3% (89/176)), and Enterococcus species (57.1% (8/14)). The majority of MDR isolates were from inpatients (58.6% (p-value < 0.0001)), males (53.77%), age group < 2 years (30.7%), and blood sample (25.22%).

CONCLUSIONS

A higher level of resistance to ampicillin, cotrimoxazole, penicillin and lower level of resistance to vancomycin, amikacin, and tobramycin were detected. Slightly lower overall rates of multidrug-resistant bacteria are isolated and a higher resistance rate is observed on Serratia species, Enterobacter species, K. pneumonia, Enterococcus species, and E. coli. Hospital admission is highly associated with the isolation of multidrug-resistant bacteria. Hence patient hospital stay should be considered in the prevention of multidrug resistant bacterial infections.