High Levels of Antibiotic Resistance Patterns in Two Referral Hospitals during the Post-Ebola Era in Free-Town, Sierra Leone: 2017–2019
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Tropical Medicine & Infection Disease
Abstract
The Post-Ebola era (2017–2019) presented an opportunity for laboratory investments in
Sierra Leone. US CDC supported the Ministry of Health and Sanitation to establish a microbiological
unit for routine antimicrobial sensitivity testing in two referral (pediatric and maternity) hospitals in
Freetown. This study describes resistance patterns among patients’ laboratory samples from 2017 to
2019 using routine data. Samples included urine, stool, cerebrospinal fluid, pus-wound, pleural fluid,
and high vaginal swabs. Selected Gram-positive and Gram-negative bacterial isolates were tested for
antimicrobial susceptibility. Of 200 samples received by the laboratory, 89 returned positive bacterial
isolates with urine and pus-wound swabs accounting for 75% of positive isolates. The number of
positive isolates increased annually from one in 2017 to 42 in 2018 and 46 in 2019. Resistance of the
cultures to at least one antibiotic was high (91%), and even higher in the pediatric hospital (94%).
Resistance was highest with penicillin (81%) for Gram-positive bacteria and lowest with nitrofurantoin (13%). Gram-negative bacteria were most resistant to ampicillin, gentamycin, streptomycin,
tetracycline, cephalothin and penicillin (100%) and least resistant to novobiocin (0%). Antibiotic
resistance for commonly prescribed antibiotics was high in two referral hospitals, highlighting the
urgent need for antimicrobial stewardship and access to reserve antibiotics.
Description
Keywords
AMR, Laboratory, AMR surveillance, Antimicrobial stewardship, Operational research, SORT IT, Sierra Leone
Citation
Koroma, Z.; Moses, F.; Delamou, A.; Hann, K.; Ali, E.; Kitutu, F.E.; Namugambe, J.S.; Harding, D.; Hermans, V.; Takarinda, K.; et al. High Levels of Antibiotic Resistance Patterns in Two Referral Hospitals during the Post-Ebola Era in Free-Town, Sierra Leone: 2017–2019. Trop. Med. Infect. Dis. 2021, 6, 103. https://doi.org/10.3390/tropicalmed 6020103