Pattern of antimicrobial resistance among patients with culture proven hospital acquired infections at AABET Hospital Addis Ababa, Ethiopia

Abstract

Abstract Background: HAI is the most frequently occurring adverse event in any healthcare system regardless of available resources. Compounding this problem is the emergence of drug resistant microorganisms which are increasing mortality and morbidity. However there is no study done showing the commonest HAI’s and degree of antimicrobial susceptibility in AABET hospital. Thus identification of degree and pattern of susceptibility of common organisms causing HAI in patients admitted to AABET Hospital will allow the tailoring of empiric antibiotic coverage based on adequate knowledge of local susceptibility pattern. Objectives: To describe the pattern of antimicrobial susceptibility in patients with culture proven HAI at AaBET Hospital, Addis Ababa, Ethiopia from August 1, 2021 to August 1,2022. Methods: An institutional based cross-sectional study over a period of one year was conducted by reviewing culture registry logs at AaBET Microbiology lab and cross checking with patient medical records of admissions made to AaBET Hospital from August 1, 2021 to August 1,2022 . Non probability whole sampling was used on all patients with culture proven HAI who meet the inclusion criteria and Subsequently data was coded and entered to EPI INFO version 3.5.3 and analysis was conducted using SPSS version 25.0 correlation and bivariant regression was done to assess association. A P- Value of less than 0.05 was taken as significant. Results- This study shows that the 4 commonest HAI that is diagnosed is surgical site infection (38.3 %) followed by CAUTI(31.2%) ,HAP(13.5%) and Tracheostomy site infection (6.7%). The most commonly isolated microorganisms were E. Coli(24.07%), Staph Spp. (CONS)(16.4%), Staph Aureus(14.7%), Klebsiella Spp.(14.3%), Pseudomonas Spp.(11.8%),Actinobacter(5.9%),Candida Spp(2.9%). High resistance is observed to Penicillins, Aztreonam & Cephalosporins especially by E. coli & Actinobacter. Additionally prior antimicrobial exposure ,presence of comorbidity, prior healthcare exposure in 90 days, surgery or intubation since admission length of stay prior to diagnosis of HAI or total hospital length of stay were not found to be associated with increased resistance in this study. Conclusion & Recommendation- High resistance is observed to Penicillins, Aztreonam & Cephalosporins especially by E. coli & Actinobacter. With High susceptibility being observed to Amikacin and Chloramphenicol, use of these antimicrobials should be encouraged to susceptible suspected or proven etiologies. Additionally hospital based prospective studies to identify burden of HAI and associated risk factors predisposing to antimicrobial resistance and transmission. Key words: culture sensitivity and specificity, VAP, HAI, CAUTI, Surgical Site Infection