CONSUMPTION AND BACTERIAL RESISTANCE TO AMINOGLYCOSIDES AT SUDANESE UNIVERSITY HOSPITAL
DOI:
https://doi.org/10.22159/ajpcr.2018.v11i8.26381Keywords:
Aminoglycosides, Resistance, Gram-negative bacteria, Hospital Prescribing, SudanAbstract
Objectives: The objective of this study was to describe patterns of antimicrobial resistance to gentamicin (Gen) and amikacin (Ak) among Gram-negative aerobic bacteria during 1-year period and to determine the association between antibiotic resistance and the consumption of Gen.
Methods: Aminoglycosides consumption at Soba University Hospital wards was measured and susceptibility of Gram-negative bacteria for the same period was evaluated. Consumption data were converted to defined daily doses (DDDs)/100 bed days based on DDD/anatomical therapeutic chemical the WHO system. The association between the frequency of strains resistant to Gen and Ak and their consumption was assessed by linear regression analysis using Spearman's correlation. The level of statistical significance was set at p<0.05.
Results: A total of 973 Gram-negative isolates were identified and tested for antimicrobial susceptibility to Gen and Ak. Resistance to Gen alone was found to be 19.42%; n=189, resistance to Ak alone was found to be 3.08%; n=30, and resistance to Gen plus Ak was found to be 5.24%; n=51. Pseudomonas aeruginosa was the most resistant pathogen to Ak plus Gen (2.26%; n=22). A positive correlation between the increases in the use of Gen and the prevalence of bacterial resistance among hospital wards was found (correlation coefficient r=0.6; p=0.04).
Conclusion: Gen and Ak are still highly active antimicrobial agents for the treatment of aerobic Gram-negative bacteria at times of intensified resistance to other antimicrobial agents. Monitoring the use of aminoglycosides is very important too.
Â
Downloads
References
Ballow CH, Schentag JJ. Trends in antibiotic utilization and bacterial resistance: Report of the national nosocomial resistance surveillance group. Diagn Microbiol Infect Dis 1992;15 Suppl:37-42.
Chamberland S, L’Ecuyer J, Lessard C, Bernier M, Provencher P, Bergeron MG, et al. Antibiotic susceptibility profiles of 941 gram-negative bacteria isolated from septicemic patients throughout Canada. The Canadian study group. Clin Infect Dis 1992;15:615-28.
Galimand M, Sabtcheva S, Courvalin P, Lambert T. Worldwide disseminated armA aminoglycoside resistance methylase gene is borne by composite transposon Tn1548. Antimicrob Agents Chemother 2005;49:2949-53.
Alekshun MN, Levy SB. Molecular mechanisms of antibacterial multidrug resistance. Cell 2007;128:1037-50.
MacLeod DL, Nelson LE, Shawar RM, Lin BB, Lockwood LG, Dirk JE, et al. Aminoglycoside resistance mechanisms for cystic fibrosis Pseudomonas aeruginosa isolates are unchanged by long-term, intermittent, inhaled tobramycin treatment. J Infect Dis 2000;181:1180-4.
Magnet S, Courvalin P, Lambert T. Resistance-nodulation-cell division-type efflux pump involved in aminoglycoside resistance in Acinetobacter baumannii strain BM4454. Antimicrob Agents Chemother 2001;45:3375-80.
Rosenberg EY, Ma D, Nikaido H. AcrD of Escherichia coli is an aminoglycoside efflux pump. J Bacteriol 2000;182:1754-6.
Hocquet D, Vogne C, El Garch F, Vejux A, Gotoh N, Lee A, et al. MexXY-OprM efflux pump is necessary for a adaptive resistance of Pseudomonas aeruginosa to aminoglycosides. Antimicrob Agents Chemother 2003;47:1371-5.
Overhage J, Bains M, Brazas MD, Hancock RE. Swarming of Pseudomonas aeruginosa is a complex adaptation leading to increased production of virulence factors and antibiotic resistance. J Bacteriol 2008;190:2671-9.
Magnet S, Smith TA, Zheng R, Nordmann P, Blanchard JS. Aminoglycoside resistance resulting from tight drug binding to an altered aminoglycoside acetyltransferase. Antimicrob Agents Chemother 2003;47:1577-83.
Ramirez MS, Tolmasky ME. Aminoglycoside modifying enzymes. Drug Resist Updat Rev Comment Antimicrob Anticancer Chemother 2010;13:151-71.
Shaw KJ, Rather PN, Hare RS, Miller GH. Molecular genetics of aminoglycoside resistance genes and familial relationships of the aminoglycoside-modifying enzymes. Microbiol Rev 1993;57:138-63.
World Health Organization (WHO). Collaboration Centre for Drug Statistics Methodology. Definition and General Considerations; 2018. Available from: https://www.whocc.no/ddd/definition_and_general_ considerations/. [Last cited on 2017 Dec 03].
Zhang W, Shen X, Bergman U, Wang Y, Chen Y, Huang M, et al. Drug utilisation 90% (DU90%) profiles of antibiotics in five Chinese children’s hospitals (2002-2006). Int J Antimicrob Agents 2008;32:250-5.
Liem TB, Heerdink ER, Egberts AC, Fademaker CM. Quantifying antibiotic use in pediatrics: A proposal for neonatal DDDs. Eur J Clin Microbiol Infect Dis 2010;29:1301-3.
Zhang W, Shen X, Wang Y, Chen Y, Huang M, Zeng Q, et al. Outpatient antibiotic use and assessment of antibiotic guidelines in Chinese children’s hospitals. Eur J Clin Pharmacol 2008;64:821-8.
Zhang W, Shen X, Wang Y, Chen Y, Huang M, Zeng Q, et al. Antibiotic use in five children’s hospitals during 2002-2006: The impact of antibiotic guidelines issued by the Chinese ministry of health. Pharmacoepidemiol Drug Saf 2008;17:306-11.
Kolář M, Urbánek K, Látal T. Antibiotic selective pressure and development of bacterial resistance. Int J Antimicrob Agents 2001;17:357-63.
Urbánek K, Kolář M, LoveÄková Y, Strojil J, Å antavá L. Influence of third-generation cephalosporin utilization on the occurrence of ESBL-positive Klebsiella pneumoniae strains. J Clin Pharm Ther 2007;32(4):403–8.
Giamarellou H, Antoniadou A. The effect of monitoring of antibiotic use on decreasing antibiotic resistance in the hospital. Ciba Found Symp 1997;207:76-86.
Sedláková MH, Urbánek K, Vojtová V, Suchánková H, Imwensi P, Kolář M. Antibiotic consumption and its influence on the resistance in Enterobacteriaceae. BMC Res Notes 2014;7:454.
Willemsen I, Bogaers-Hofman D, Winters M, Kluytmans J. Correlation between antibiotic use and resistance in a hospital: Temporary and ward-specific observations. Infection 2009;37:432-7.
Cheesbrough M. District Laboratory Practice in Tropical Countries Part. 2nd ed. Cambridge: Cambridge University Press; 2006. p. 132-42.
National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Susceptibility Testing. NCCLS Approved Standard M100-S17. Wayne, PA: National Committee for Clinical Laboratory Standards; 2007.
Harbarth S, Rohner P, Safran E, Garbino J, Auckenthaler R, Pittet D. Resistance to amikacin and gentamicin among Gram-negative bloodstream isolates in a university hospital between 1989 and 1994. Clin Microbiol Infect Off Publ Eur Soc ClinMicrobiol Infect Dis 1998;4:199-204.
Korvick JA, Bryan CS, Farber B, Beam TR, Schenfeld L, Muder RR, et al. Prospective observational study of Klebsiella bacteremia in 230 patients: Outcome for antibiotic combinations versus monotherapy. Antimicrob Agents Chemother 1992;36:2639-44.
Shimizu K, Kumada T, Hsieh WC, Chung HY, Chong Y, Hare RS, et al. Comparison of aminoglycoside resistance patterns in Japan, Formosa, and Korea, Chile, and the United States. Antimicrob Agents Chemother 1985;28:282-8.
Lai CC, Wang CY, Chu CC, Tan CK, Lu CL, Lee YC, et al. Correlation between antibiotic consumption and resistance of gram-negative bacteria causing healthcare-associated infections at a university hospital in Taiwan from 2000 to 2009. J Antimicrob Chemother 2011;66:1374-82.
Doogue MP. Correlations between aminoglycoside consumption and aminoglycoside resistance in Gram-negative bacteria at a tertiary-care hospital in South Korea from 2001 to 2011. Int J Antimicrob Agents 2013;41:393-401.
Ibrahim ME, Bilal NE, Hamid ME. Increased multi-drug resistant Escherichia coli from hospitals in Khartoum state, Sudan. Afr Health Sci 2012;12:368-75.
Nurain AM, Bilal NE, Ibrahim ME. The frequency and antimicrobial resistance patterns of nosocomial pathogens recovered from cancer patients and hospital environments. Asian Pac J Trop Biomed 2015;5:1055-9.
Divyashanthi CM, Adithiyakumar S, Bharathi N. Studyof prevalence and antimicrobial susceptibility pattern of bacterial isolates in a tertiary care hospital. Int J Pharm Pharm Sci 2015;7:185-90.
Murugan N, Malathi J, Therese KL, Madhavan HN. Antimicrobial susceptibility and prevalence of extended spectrum betalactamases (ESBL) and metallobetalactamases (MBL) and its co-existence among Pseudomonas aeruginosa recovered from ocular infections. Int J Pharm Pharm Sci 2015;7:147-51.
Published
How to Cite
Issue
Section
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.