A Six Years' Trend Analysis of Antimicrobial Resistance Among Bacterial Isolates at Public Health Institute in Amhara Region, Ethiopia.

Abstract

Background: Antimicrobial resistance (AMR) is one of the top global threats to public health. This study determined trends in AMR from 2016 to 2021 in a regional research laboratory in Northwest Ethiopia. Methods: Data from 2016 to 2021 was extracted from a database. Bacterial identification and resistance tests were made using the standard microbiologic procedures. The results were described, trends in AMR were determined using polynomial regressions, and binary logistic regression at p value < 0.05 was used. Results: From 2016 to 2021, 25,143 specimens were sent for culture and susceptibility testing, among which 16,825 (66.9%) bacteria were isolated. About 12,528 (74.5%) isolates were gram-negative, and 4297 (25.5%) were gram-positive. Klebsiella pneumoniae (3783, 30.2%) and Escherichia coli (3199, 25.5%) were the most common gram-negative bacteria, whereas coagulase-negative Staphylococcus spp. (CoNS) (1765, 40.1%) and Staphylococcus aureus (1293, 30.1%) were the most common gram-positive bacteria. The overall prevalence of AMR was 2738 (59.9%), of which about 1807 (66.0%) accounted for gram-negative and 931 (34.0%) for gram-positive bacteria. K. pneumoniae (743, 80.2%), Enterobacter cloacae (196, 74.8%), and Acinetobacter baumannii (213, 66.6%) were the most common resistant isolates among gram-negative bacteria, while CoNS (406, 58%), Streptococcus species (34, 50%), and S. aureus (196, 37%) were from gram-positive bacteria. About 571 (20.9%) of bacteria were resistant to 2-10 drugs. The overall trend of AMR has been rising from year to year, reaching a peak in 2019 which was approximately 66% and then after has been predicted to decline. Conclusion: AMR in the regional laboratory is prevalent and has been increasing although the quadratic equation has revealed downward-opening parabola over time. A growing number of multidrug-resistant bacteria are an alarm to awaken policymakers and those concerned to intervene before it is too late. This calls for a periodic, integrated, and continuing system to monitor AMR for commonly used antibiotics.