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Cited by 42Antibiotic Resistance in BacteriaAntibiotic Use and ResistanceBacterial Identification and Susceptibility Testing

Prevalence and Antimicrobial Resistance of Microbes Causing Bloodstream Infections in Unguja, Zanzibar

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Onken, Annette, Said, Abdulrahman K., Jørstad, Melissa, Jenum, Pål A., Blomberg, Bjørn·2015·PLOS ONE
DOI 10.1371/journal.pone.0145632PMC PMC4689456
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Abstract

BACKGROUND: Bloodstream infections (BSI) are frequent and cause high case-fatality rates. Urgent antibiotic treatment can save patients' lives, but antibiotic resistance can render antibiotic therapy futile. This study is the first to collect epidemiological data on BSI from Unguja, Zanzibar. METHODS: Clinical data and blood for culturing and susceptibility testing of isolated microbes were obtained from 469 consecutively enrolled neonates, children and adults presenting with signs of systemic infections at Mnazi Mmoja Hospital (MMH), Zanzibar. RESULTS: Pathogenic bacteria were recovered from the blood of 14% of the patients (66/469). The most frequently isolated microbes were Klebsiella pneumoniae, Escherichia coli, Acinetobacter spp. and Staphylococcus aureus. Infections were community-acquired in 56 patients (85%) and hospital-acquired in 8 (12%) (data missing for 2 patients). BSI caused by extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae (E. coli, K. pneumoniae) was found in 5 cases, of which 3 were community-acquired and 2 hospital-acquired. Three of these patients died. Six of 7 Salmonella Typhi isolates were multidrug resistant. Streptococcus pneumoniae was found in one patient only. CONCLUSIONS: This is the first report of ESBL-producing bacteria causing BSI from the Zanzibar archipelago. Our finding of community-acquired BSI caused by ESBL-producing bacteria is alarming, as it implies that these difficult-to-treat bacteria have already spread in the society. In the local setting these infections are virtually impossible to cure. The findings call for increased awareness of rational antibiotic use, infection control and surveillance to counteract the problem of emerging antimicrobial resistance.

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  • Mounting evidence demonstrates the emergence of Acinetobacter as a cause of hospital-associated and occasionally community-acquired infection in resource-limited settings.

    “mounting evidence demonstrates the emergence of this pathogen as a cause of hospital-associated and occasionally community-acquired infection in resource-limited settings.[5, 16–20]”

    From Antimicrobial-resistant infections among postpartum women at a Ugandan referral hospital (2017) · cites this paper as [17]

    The Results > Microbes table reports Acinetobacter bloodstream infections in both community- and hospital-acquired cases in Zanzibar. But nine of the ten Acinetobacter isolates were community-acquired, so this study does not support describing community acquisition as only occasional; it also does not establish an emergence trend. Our copy provides no page number for the table. (LLM, conf=0.87)

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  1. [7]Collee JG M B, Irvine R, Fraser AG, Simmons A, editor (1996) Mackie & McCartney Practical Medical Microbiology. 14th edition ed New York: Churchill Livingstone.

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Authors
Onken, A., Said, A. K., Jørstad, M., Jenum, P. A., & Blomberg, B.
Affiliations
  • Vestre Viken Hospital Trust (NO)
  • Haukeland University Hospital (NO)
Corresponding author
  • Onken, Annette
  • Said, Abdulrahman K.
  • Jørstad, Melissa
  • Jenum, Pål A.
  • Blomberg, Bjørn
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2015-12-23
Volume
10
Issue
12
Pages
e0145632
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0145632
PMC
PMC4689456
OpenAlex
W2236517210
Cited by
42
References
34
Citations by year
2026: 3 · 2025: 4 · 2024: 3 · 2023: 5 · 2022: 2 · 2021: 6 · 2020: 7 · 2019: 5 · 2018: 1 · 2017: 4 · 2016: 2
FWCI
0.97
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
Funders
Haukeland Universitetssjukehus
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
Keywords
bloodstream infection, antimicrobial resistance, extended-spectrum beta-lactamase, ESBL-producing Enterobacteriaceae, Klebsiella pneumoniae, Escherichia coli, Acinetobacter, Staphylococcus aureus, Salmonella typhi, multidrug resistance, community-acquired infections, nosocomial infections, Zanzibar, antibiotic use, infection control
MeSH terms
Adolescent, Adult, Anti-Bacterial Agents, Child, Child, Preschool, Cross Infection, Drug Resistance, Microbial, Female, Humans, Infant, Infant, Newborn, Male, Tanzania, Prevalence, Bacteremia, Community-Acquired Infections

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