Antimicrobial Resistance in Surgical Patients at the University Teaching Hospital of Kigali: A Cross-Sectional Study.

Abstract

Antimicrobial resistance (AMR) poses a major threat to public health worldwide. In Africa, the overall burden of AMR is not well understood or documented because of inadequate data and lack of surveillance, and empirical treatment takes a major part in the clinical management of infections. We assessed AMR in infected surgical wounds at the University Teaching Hospital of Kigali from January 1st to December 31st, 2022. The study analyzed a total of 136 swab cultures from the surgery department; 89 (65.4%) were culture positive and included in the analysis. The mean age of patients with positive culture was 37 ± 17 years old, and the sex distribution consisted of 65 males (73%) and 24 females (27%). Data were analyzed using SPSS v. 21. The study identified a diverse array of different bacterial isolates. Escherichia coli was the most prevalent (19.1%) followed by Staphylococcus aureus (17%) and Klebsiella pneumoniae (16%). Other notable isolates included Citrobacter freundii (11%), Pseudomonas aeruginosa (9%), and Acinetobacter baumannii (9%). Acinetobacter and Klebsiella had higher resistance rates of 80% and 76.5%, respectively. The average resistance rate across all isolates was 63%. Moreover, among the 89 patients who had positive swab culture results, 86 (96.6%) recovered completely, and 3 (3.4%) died. The study highlights a high level of antibiotic resistance, particularly among common Gram-negative pathogens, emphasizing the need for ongoing monitoring and the development of targeted treatment strategies to address this public health challenge.