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Bacterial infections in Lilongwe, Malawi: aetiology and antibiotic resistance.

Publication ,  Journal Article
Makoka, MH; Miller, WC; Hoffman, IF; Cholera, R; Gilligan, PH; Kamwendo, D; Malunga, G; Joaki, G; Martinson, F; Hosseinipour, MC
Published in: BMC Infect Dis
March 21, 2012

BACKGROUND: Life-threatening infections present major challenges for health systems in Malawi and the developing world because routine microbiologic culture and sensitivity testing are not performed due to lack of capacity. Use of empirical antimicrobial therapy without regular microbiologic surveillance is unable to provide adequate treatment in the face of emerging antimicrobial resistance. This study was conducted to determine antimicrobial susceptibility patterns in order to inform treatment choices and generate hospital-wide baseline data. METHODS: Culture and susceptibility testing was performed on various specimens from patients presenting with possible infectious diseases at Kamuzu Central Hospital, Lilongwe, Malawi. RESULTS: Between July 2006 and December 2007 3104 specimens from 2458 patients were evaluated, with 60.1% from the adult medical service. Common presentations were sepsis, meningitis, pneumonia and abscess. An etiologic agent was detected in 13% of patients. The most common organisms detected from blood cultures were Staphylococcus aureus, Escherichia coli, Salmonella species and Streptococcus pneumoniae, whereas Streptococcus pneumoniae and Cryptococcus neoformans were most frequently detected from cerebrospinal fluid. Haemophilus influenzae was rarely isolated. Resistance to commonly used antibiotics was observed in up to 80% of the isolates while antibiotics that were not commonly in use maintained susceptibility. CONCLUSIONS: There is widespread resistance to almost all of the antibiotics that are empirically used in Malawi. Antibiotics that have not been widely introduced in Malawi show better laboratory performance. Choices for empirical therapy in Malawi should be revised accordingly. A microbiologic surveillance system should be established and prudent use of antimicrobials promoted to improve patient care.

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Published In

BMC Infect Dis

DOI

EISSN

1471-2334

Publication Date

March 21, 2012

Volume

12

Start / End Page

67

Location

England

Related Subject Headings

  • Young Adult
  • Middle Aged
  • Microbiology
  • Microbial Sensitivity Tests
  • Male
  • Malawi
  • Infant, Newborn
  • Infant
  • Humans
  • Female
 

Citation

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Makoka, M. H., Miller, W. C., Hoffman, I. F., Cholera, R., Gilligan, P. H., Kamwendo, D., … Hosseinipour, M. C. (2012). Bacterial infections in Lilongwe, Malawi: aetiology and antibiotic resistance. BMC Infect Dis, 12, 67. https://doi.org/10.1186/1471-2334-12-67
Makoka, Mwai H., William C. Miller, Irving F. Hoffman, Rushina Cholera, Peter H. Gilligan, Debbie Kamwendo, Gabriel Malunga, George Joaki, Francis Martinson, and Mina C. Hosseinipour. “Bacterial infections in Lilongwe, Malawi: aetiology and antibiotic resistance.BMC Infect Dis 12 (March 21, 2012): 67. https://doi.org/10.1186/1471-2334-12-67.
Makoka MH, Miller WC, Hoffman IF, Cholera R, Gilligan PH, Kamwendo D, et al. Bacterial infections in Lilongwe, Malawi: aetiology and antibiotic resistance. BMC Infect Dis. 2012 Mar 21;12:67.
Makoka, Mwai H., et al. “Bacterial infections in Lilongwe, Malawi: aetiology and antibiotic resistance.BMC Infect Dis, vol. 12, Mar. 2012, p. 67. Pubmed, doi:10.1186/1471-2334-12-67.
Makoka MH, Miller WC, Hoffman IF, Cholera R, Gilligan PH, Kamwendo D, Malunga G, Joaki G, Martinson F, Hosseinipour MC. Bacterial infections in Lilongwe, Malawi: aetiology and antibiotic resistance. BMC Infect Dis. 2012 Mar 21;12:67.
Journal cover image

Published In

BMC Infect Dis

DOI

EISSN

1471-2334

Publication Date

March 21, 2012

Volume

12

Start / End Page

67

Location

England

Related Subject Headings

  • Young Adult
  • Middle Aged
  • Microbiology
  • Microbial Sensitivity Tests
  • Male
  • Malawi
  • Infant, Newborn
  • Infant
  • Humans
  • Female