Browsing by Author "Walusimbi, Apollo"

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    Methicillin Resistant Staphylococcus Aureus Among Patients On The General Wards At Kawolo General Hospital, Uganda.
    (International Health Sciences University., 2015-12) Walusimbi, Apollo
    Introduction: Over time there has been a global increase of antimicrobial resistances among Staphylococcus aureus (S. aureus) with MRSA persistently becoming rampant especially among hospitalized patients. This has limited the choices for management with increasing treatment costs. Aim: This study aimed at establishing the prevalence of Methicillin Resistant S. aureus among patients admitted in the general wards at Kawolo general hospital, Uganda. Methodology: A cross sectional laboratory based experimental study was done. Samples included nasal and wound swabs from patients on female, male, and the peadiatric wards to isolate S. aureus that colonised the nares or caused wound infections. Drug susceptibility was done by Kirby Bauer method from which Methicillin resistant S. aureus (MRSA) were identified. Also, Multi drug resistant (MDR) and possible Extra drug resistant (XDR) S. aureus were identified. Results: A total of 204 samples were collected from 87 (42.57%) females and 117 (57.43%) males. Samples that grew organisims were 182 (89.2%) while 22 (10.8%) showed no growth. Among those that grew, 102/182 (56.04%) were S. aureus while 80/182 (43.96%) were other organisims. Among the S. aureus isolates, 44/102 (43.14%) were MRSA while 58/102 (56.86%) were MSSA. Samples from the female, male, and the peadiatric wards showed that 8/26 (30.77%), 26/50 (52%), 10/26 (38.46%) participants had MRSA respectively. Susceptibility testing showed that S. aureus was more susceptible to vancomycin > Gentamycin > Clindamycin > Erythromycin > Penicillin G > Trimethoprim sulfamethoxazole. Against the MRSA isolates, only vancomycin showed excellent performance with 100% sensitivity followed by gentamycin with a sensitivity of 24/44 (54.55%) but MRSA was a big predictor of gentamycin resistance (OR: 11.25, P-Value < 0.0001). A total of 92 (90.2%) S. aureus isolates were resistant to at least one antibiotic used among which 46/92 (45.10%) isolates were MDR, while 14/92 (13.73%) isolates were possible XDR. Conclusion: There is a high prevalence of MRSA in Kawolo general hospital. Before treatment, antimicrobial susceptibility should be done or where facilities are unavailable, vancomycin should be the drug of choice in empirical treatment/management of infections with MRSA. Also Trimethoprim sulfamethoxazole and Penicillins should not be used in any presumed MRSA infection in all places with limited isolation facilities.
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    Microbial contaminants isolated from itemsand work surfaces in the post- operativeward at Kawolo general hospital, Uganda
    (Bio Med Central, 2018-02-06) Sserwadda, Ivan; Lukenge, Mathew; Mwambi, Bashir; Mboowa, Gerald; Walusimbi, Apollo; Segujja, Farouk
    Background: Nosocomial infections are a major setback in the healthcare delivery system especially in developing countries due to the limited resources. The roles played by medical care equipment and work surfaces in the transmission of such organisms have inevitably contributed to the elevated mortality, morbidity and antibiotic resistances. Methods: A total of 138 samples were collected during the study from Kawolo general hospital. Swab samples were collected from various work surfaces and fomites which consisted of; beds, sink taps, infusion stands, switches, worktables and scissors. Cultures were done and the susceptibility patterns of the isolates were determined using Kirby-Bauer disc diffusion method. Data was analyzed using Stata 13 and Microsoft Excel 2013 packages. Results: A total of 44.2% (61/138) of the collected swab specimens represented the overall bacterial contamination of the sampled articles. Staphylococcus aureus and Klebsiella pneumonia accounted for the highest bacterial contaminants constituting of 75.4% (46/61) and 11.5% (7/61) respectively. Infusion stands and patient beds were found to have the highest bacterial contamination levels both constituting 19.67% (12/61). The highest degree of transmission of organisms to patients was found to be statistically significant for patient beds with OR: 20.1 and p-value8X10−4.Vancomycin, ceftriaxone and ciprofloxacin were the most effective antibiotics with 100%, 80% and 80% sensitivity patterns among the isolates respectively. Multi-drug resistant (MDR)Staphylococcus aureus accounted for 52% (24/46)with 4% (1/24) classified as a possible extensively drug-resistant (XDR) whereas Gram-negative isolates had 27% (4/15)MDR strains out of which 50%(2/4) were classified as possible pan-drug resistant (PDR).Conclusion:The high prevalence of bacterial contaminants in the hospital work environment is an indicator of poor orineffective decontamination. The study findings reiterate the necessity to formulate drug usage policies and re-examine the effectiveness of decontamination and sterilization practices within Kawolo general hospital. We also recommend the installation of a sound Microbiology unit at the hospital to take on susceptibility testing to check on the empirical use of antibiotics as a way of reducing the rampant elevations in drug resistance.