Surgical Site Infections and Antimicrobial Resistance After Cesarean Section Delivery in Rural Rwanda
| العنوان: | Surgical Site Infections and Antimicrobial Resistance After Cesarean Section Delivery in Rural Rwanda |
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| المؤلفون: | Gilbert Rukundo, Moses Muwanguzi, Bethany Hedt-Gauthier, Ivan Emil, Theoneste Nkurunziza, Fredrick Kateera, Grace Umutesi, Kara Faktor, Lisa M. Bebell, Marthe Yankurije, Lotta Velin, Robert Riviello, Jean de Dieu Gatete |
| المصدر: | Annals of Global Health Annals of Global Health, Vol 87, Iss 1 (2021) |
| بيانات النشر: | Ubiquity Press, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Adult, medicine.medical_specialty, medicine.drug_class, Cefepime, Antibiotics, Infectious and parasitic diseases, RC109-216, Microbial Sensitivity Tests, Gram-Positive Bacteria, Surgical prophylaxis, Antibiotic resistance, Pregnancy, Ampicillin, Internal medicine, Epidemiology, Drug Resistance, Bacterial, Gram-Negative Bacteria, medicine, Humans, Surgical Wound Infection, Prospective Studies, Gram-Positive Bacterial Infections, Original Research, biology, business.industry, Cesarean Section, Rwanda, General Medicine, biology.organism_classification, Acinetobacter baumannii, Anti-Bacterial Agents, Ceftriaxone, Female, Public aspects of medicine, RA1-1270, business, Gram-Negative Bacterial Infections, medicine.drug |
| الوصف: | Background: As the volume of surgical cases in low- and middle-income countries (LMICs) increases, surgical-site infections (SSIs) are becoming more prevalent with anecdotal evidence of antimicrobial resistance (AMR), despite a paucity of data on resistance patterns. Objectives: As a primary objective, this prospective study aimed to describe the epidemiology of SSIs and the associated AMR among women who delivered by cesarean at a rural Rwandan hospital. As secondary objectives, this study also assessed patient demographics, pre- and post-operative antibiotic use, and SSI treatment. Methods: Women who underwent cesarean deliveries at Kirehe District Hospital between September 23rd, 2019, and March 16th, 2020, were enrolled prospectively. On postoperative day (POD) 11 (+/− 3 days), their wounds were examined. When an SSI was diagnosed, a wound swab was collected and sent to the Rwandan National Reference Laboratory for culturing and antibiotic susceptibility testing. Findings: Nine hundred thirty women were enrolled, of whom 795 (85.5%) returned for the POD 11 clinic visit. 45 (5.7%) of the 795 were diagnosed with SSI and swabs were collected from 44 of these 45 women. From these 44 swabs, 57 potential pathogens were isolated. The most prevalent bacteria were coagulase-negative staphylococci (n = 12/57, 20.3% of all isolates), and Acinetobacter baumannii complex (n = 9/57, 15.2%). 68.4% (n = 39) of isolates were gram negative; 86.7% if excluding coagulase-negative staphylococci. No gram-negative pathogens isolated were susceptible to ampicillin, and the vast majority demonstrated intermediate susceptibility or resistance to ceftriaxone (92.1%) and cefepime (84.6%). Conclusions: Bacterial isolates from SSI swab cultures in rural Rwanda predominantly consisted of gram-negative pathogens and were largely resistant to commonly used antibiotics. This raises concerns about the effectiveness of antibiotics currently used for surgical prophylaxis and treatment and may guide the appropriate selection of treatment of SSIs in rural Rwanda and comparable settings. |
| اللغة: | English |
| تدمد: | 2214-9996 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5709e92d6ec35e5415842338e443c5a8 http://europepmc.org/articles/PMC8344956 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....5709e92d6ec35e5415842338e443c5a8 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 22149996 |
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