Abstract:

Background: Antimicrobial resistance (AMR) is a public health problem and threat all over the world. The increased emergence of new resistant strains of bacteria pose the threat to clinical practices and public health as well. Available information is limited to Bugando medical centre in Mwanza from 2013 to 2015. This study determined a four years trend of AMR from bacterial clinical isolates at Bugando medical centre in Mwanza, Tanzania.

Material and methods: This hospital based retrospective study was conducted between April and July 2019 on antibacterial susceptibility results from June 2015 to May 2019 at Bacteriology section, Bugando medical centre. Antibiotic susceptibility results from archives were collected, entered and analysed using WHONET software according to study specific objective. After data analysis, frequency results per year were presented in graphic format to determine trends of AMR among clinical isolates between June 2015 and May 2019.

Results: Out of 4,393 microbiological report forms, 4414 bacteria were isolated of which prevalent bacteria reported were Staphylococcus aureus; 1017 (23%). Mostly, positive cultures were from National Health Insurance clients; 781 (18%). Gram positive showed increased resistance to tetracycline, clindamycin and vancomycin from 58.3%, 29.3% and 2.8% in 2015 to 69.6%, 42.4% and 12.1% in 2019 in 2018-2019. Gram negative bacteria showed decreased resistance to cefotaxime, ceftriaxone, gentamicin and imipenem from 70%, 73.4%, 59% and 6.1% in 2015 – 2016 to 54.2%, 51.4%, 39.5% and 2.9% in 2018 – 2019 respectively, while resistance to ciprofloxacin increased from 34.9% in 2015 to 35.6% in 2019. Proportion of ESBL decreased from 73.4% to 51.4% between 2015-2019 and that of MRSA from 4.6% to 2.1% between 2017 and 2019 respectively.

Conclusion: Antimicrobial stewardship should be applied at Bugando medical centre as well as in the community so as to guide rational use of antibiotics so as to stop or slow down the emergence of resistance.