article · Tanzania Medical Journal
This study investigated the causes and antibiotic resistance patterns of bloodstream infections (BSI) in chronic kidney disease (CKD) patients at a Tanzanian hospital. Researchers analysed blood samples from 200 CKD patients, identifying bacteria and testing their susceptibility to antibiotics. The study found a BSI prevalence of 37.5% among CKD patients, with 41.7% of those on dialysis experiencing BSI. Gram-negative bacteria were predominant, notably Pseudomonas aeruginosa and Escherichia coli. Among Gram-positive bacteria, Coagulase-negative staphylococcus was most frequent. Many isolated bacteria showed high resistance to commonly used antibiotics, such as ciprofloxacin, ampicillin, and penicillin. These findings highlight a significant issue of antibiotic resistance in BSI among CKD patients in this setting.
Chronic kidney disease patients are vulnerable to serious bloodstream infections, which are often complicated by antibiotic resistance. This research provides crucial data on the specific bacteria causing these infections and their resistance patterns in a Tanzanian hospital, informing better treatment strategies and highlighting the need for effective antibiotic management programmes.
The abstract does not indicate a direct application pathway for commercialisation. However, the findings provide critical epidemiological data on antibiotic resistance, which could inform the development of local antibiotic guidelines, diagnostic tools for rapid resistance detection, or targeted antimicrobial stewardship programmes. This is early-stage research providing foundational knowledge for clinical practice improvements.
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Background Patients with chronic kidney disease (CKD) are at an increased risk of acquiring bloodstream infections (BSI), particularly during dialysis. Using catheters and other invasive devices can serve as potential sources of infection. Resistant bacteria isolated from CKD patients with BSI significantly contribute to higher morbidity and mortality rates among these patients compared to the general population. Methodology A laboratory-based cross-sectional study was conducted to analyse blood samples collected from patients with CKD at Muhimbili National Hospital, Dar es Salaam, Tanzania. Two pairs of blood culture bottles were collected from each patient and incubated in the BACTEC™ FX 04 system. Positive blood cultures were then sub-cultured on solid media for isolation. Gram staining and conventional biochemical tests were performed for bacterial identification. Antimicrobial susceptibility testing was carried out using the Kirby-Bauer disc diffusion method. The patient’s clinical data were obtained from their files. The Statistical Package for Social Sciences version 25 was used for data analysis. A p-value < 0.05 was considered statistically significant. Results Two hundred participants with CKD receiving care at the nephrology and dialysis wards were enrolled. Most, 90/200 (45.0%), were adults aged 40-60, and males contributed 118/200 (59%). The prevalence of BSI among CKD patients was 75/200(37.5%). BSI was in 43/103 (41.7%) of participants receiving dialysis. Among the isolated bacteria, the Gram-negative bacteria were the predominant contributors, accounting for 43/75 (57.3%). The most frequent Gram-negative bacteria were Pseudomonas aeruginosa 13/43 (30.2%) and Escherichia coli 12/43 (27.9%). On the other hand, among the isolated Gram-positive bacteria, Coagulase negative staphylococcus (CoNS) was frequent, 23/32 (71.9%). Among the Gram-negative bacteria, Pseudomonas aeruginosa and Klebsiella pneumoniae demonstrated the highest resistance to ciprofloxacin, with rates of 75% and 90%, respectively. Meanwhile, Escherichia coli showed the highest resistance to ampicillin at 77%. Among Gram-positive bacteria, CoNS and Staphylococcus aureus exhibited the highest resistance to penicillin, with rates of 90% and 85.7%, respectively. Conclusion The present study has revealed that a significant proportion of CKD patients have BSI, and the isolated bacteria were resistant to commonly used antibiotics in our settings. These findings underscore the need to address antibiotic resistance through enhanced antimicrobial stewardship in our setting.
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DOI: 10.4314/b3rdkf50
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