Date of Award

January 2015

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Debbie L. Humphries

Abstract

Antimicrobial resistance (AMR), the phenomenon of decreased sensitivity to pharmaceutical agents that kill or inhibit the growth of bacterial pathogens, is a serious threat to public health worldwide. Many countries, including Rwanda, lack current information on antibiotic sensitivity profiles that would greatly aide clinicians and policy-makers. The current study aims to describe the time trends of antibiotic sensitivity for the isolates of six different bacterial pathogens from patients at King Faisal Hospital in Kigali, Rwanda and to make inference about future patterns of drug resistance in the study setting, to guide physicians in their prescribing practices and provide baseline data for future interventions. This was a retrospective observational study that involved data collection of the frequency and antimicrobial sensitivity patterns of bacterial organisms isolated from cultures of clinical specimens collected from patients at the King Faisal Hospital in Kigali, Rwanda. Data were collected over a five-year period from January 1, 2009 to December 31, 2013. Cochran-Armitage test and Somers’ D statistic were used to determine trends in antibiotic sensitivity over time. Analysis found that the majority of isolates collected over the study period were of E. coli (46.7%). Amongst the gram-negative species, Colistin consistently elicited the highest average annual antibiotic sensitivity. Notably, Acinetobacter spp. showed the greatest resistance to all antibiotics, relative to other species of its group. Vancomycin showed the greatest activity against gram-positive bacteria. Trend analysis determined that Imipenem and Pipercillin demonstrated negative annual sensitivity trends more often than any other antibiotics. AMR trends showed that decreased bacterial sensitivity to Imipenem and Pipercillin is increasing over time and limits the usefulness of the drugs for empiric therapy of gram infections.

Comments

This is an Open Access Thesis.

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