Antimicrobial susceptibility pattern of bacterial isolates from pus samples at Kenyatta National Hospital, Kenya

Abstract

Background: Antimicrobial resistance is not only increasing the healthcare costs but also the severity and death rates from certain infections that could have been avoided by prudent and rational use of the existing and newer antimicrobial agents. Emerging multidrug resistant strains and changing antimicrobial resistance pose challenge in treating pyogenic infections. This study will guide the clinician in choosing appropriate antimicrobials which not only contribute to better treatment but their judicious use will also help in preventing emergence of resistance to the drugs which are still sensitive. Objective This study aims to identify bacteria isolates from pus samples along with their antimicrobial susceptibility patterns at Kenyatta National Hospital. Methodology This was a retrospective study conducted at Kenyatta National Hospital medical microbiology laboratory involving review of patient’s medical laboratory records of bacterial isolates from pus samples tested for antimicrobial susceptibility during the period January 2013 to December 2013. Information regarding the patient’s age, sex, bacterial organisms isolated, department where the pus sample was obtained and antimicrobial susceptibility reports was extracted. This was collected in a data collection form which was used as a study instrument. Data analysis was done using SPSS version 21. (Statistical Package for Social Sciences). Results Out of four hundred and six pus samples, five hundred and eighteen organisms were isolated. S.aureus was the most frequent isolate (29.9%), followed by Pseudomonas spp (13.7%), E.coli (12%), Proteus spp (9.7%), Klebsiella spp (7.5%), Acinetobacter spp (7.1%), Citrobacter (6%), Enterococcus (4.6%), Enterobacter (4.4%), CONS (3.9%), S.pyogenes (0.8%), S.agalactiae (0.2%) and S.viridans (0.2%). Gram positive isolates were most susceptible to vancomycin, levofloxacin, linezolid and teicoplanin. Majority of gram negative isolates were most sensitive to imipenem, meropenem, amikacin and levofloxacin. Most resistance of gram negative isolates was shown to ampicillin, augmentin, cotrimoxazole, doxycycline and cephalosporins. Conclusion and Recommendations. S.aureus was the predominant isolate. There was high resistance to the commonly used antimicrobials. 60.2% of the isolates were multi-drug resistant. There should be continuous surveillance to monitor aetiology and antimicrobial susceptibility patterns to guide the empirical use of antimicrobials