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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Bacterial infections in Lilongwe, Malawi: Aetiology and antibiotic resistance
BMC Infectious Diseases, Volume 12, Article 67, Year 2012
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Description
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. © 2012 Makoka et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Makoka, Mwai H.
Malawi, Lilongwe
National Aids Commission
Miller, William C.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Hoffman, Irving F.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Cholera, Rushina
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Gilligan, Peter H.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Kamwendo, Deborah D.
Malawi, Lilongwe
Unc Project-malawi
Malunga, Gabriel
Malawi, Lilongwe
Unc Project-malawi
Joaki, George R.F.
Malawi, Lilongwe
Unc Project-malawi
Martinson, Francis E.A.
Malawi, Lilongwe
Unc Project-malawi
Hosseinipour, Mina C.
Malawi, Lilongwe
Unc Project-malawi
Statistics
Citations: 53
Authors: 10
Affiliations: 3
Identifiers
Doi:
10.1186/1471-2334-12-67
e-ISSN:
14712334
Research Areas
Health System And Policy
Infectious Diseases
Study Locations
Malawi