Abstract:

Background: The burden of antimicrobial resistance is rapidly growing across antibiotic classes, with increased detection of isolate resistant to carbapenems and vancomycin. The emergency of resistant to carbapenems in GNB, including enterobactericeae, Pseudomonas aeuroginosa and Acinetobacter species, over the last decade has become a major public health crisis worldwide, because of their rapid spread and lack of development of new antimicrobial drugs. The emergency of vancomycin enterococci during the last decade has made difficult to treat nosocomial infections.

This study aimed to determine the surveillance of carbapenem resistance gram negative rods and vancomycin resistance gram positive bacteria at Bugando Medical Center.

Methodology: This was an analytical cross sectional-based study, involving 350 isolates from different samples collected between October 2020 to October 2021 at Bugando Medical Center.Using simple random sampling method, the isolates were selected and proportion of carbapenem resistance and vancomycin resistance were established. Thegram-negativerodsisolates were grown in Muller Hinton Agar [MHA] and examined for the pattern of carbapenamaseresistance using Modified Hodge Test technique.Data were analyzed by STATA version 13.

Results: The mean age of enrolled participants was 31[SD ±26] years. Majority were female 50.5%(960/1902). The overall prevalence of Carbapenem resistance gram negative rods and vancomycin resistance gram positive rods are 12.6%(174/1385)[95% CI: 0.108-0.143] and 32.5%(168/517)[95% CI:0.285-0.367] respectively. Being in-patient (OR: 1.09, 95% CI: 0.73-1.65, P=0.046) and (OR: 2.51, 95%CI: 1.76-3.60, P=0.000) was significantly associated with vancomycin resistance gram positive bacteria and carbapenem resistance gram negative rods respectively.Being male (OR:1.93, 95%CI: 1.37-2.71, P=0.000), also showed association with carbapenem resistance gram negative rods.

Conclusion:This study observed an increase in prevalence of carbapenem-resistance gram negative rods and vancomycin-resistance gram positive bacteria in Mwanza, Tanzania.We recommend routine testing for carbapenem resistance among the MDRGNB and vancomycin resistance(VRSA/VRE) in our hospital and other health facilities in developing countries where there is high prevalent CREs and VREs.