@article{Namusoosa_R-2024_183465,
title = {The epidemiology of antibiotic-resistant clinical pathogens in Uganda},
author = {Namusoosa, R. and Mugerwa, I. and Kasozi, K. and Muruta, A. and Najjuka, G. and Atuhaire, W. and Nabadda, S. and Mwebesa, H. and Olaro, C. and Ssewanyana, I. and Ssemaganda, A. and Muwonge, A.},
month = {aug},
year = {2024},
abstract = {Background: Antibiotic resistance (ABR) is a global challenge, and its control depends on robust evidence primarily derived from surveillance systems. Methods: Here, we utilize a national surveillance dataset to demonstrate how such evidence can be systematically generated. In doing so, we characterize the ABR profiles of priority clinical pathogens and identify factors associations , as well as draw inferences on antibiotic usage in Uganda. Results: Of the 12,262 samples collected between 2019 and 2021, 9033 with complete metadata were analyzed. ABR was steadily increasing at a rate of 0.5 per year, with a surge in 2021, with the highest and lowest levels to penicillin and carbapenems, detected in the northern (OR=2.26, P &lt; 0.001) and the northeast (OR=0.28, P &lt; 0.001) regions of Uganda respectively. ABR was commonly observed with Escherichia coli (OR=1.18, P &lt; 0.001) and Klebsiella pneumoniae (OR=1.25, P &lt; 0.001), among older and male patients, i.e. 61–70-year-olds (OR=1.88, P=0.005). Multi-drug resistance (MDR) and ABR were disproportionately higher among bloodstream infections compared to respiratory tract infections and urinary tract infections, often caused by Acinetobacter baumannii. Co-occurrence of ABR suggests that cephalosporins such as ceftriaxone are in high use all over Uganda. Conclusions: ABR is indeed a silent pandemic, and our results suggest it is increasing at 0.5% per year, with a notable surge in 2021 likely due to COVID-19. Of concern, ABR and MDR are mainly associated with bloodstream and surgical wound infections, with a gender and age dimension. However, it is encouraging that carbapenem resistance remains relatively low. Such evidence is critical for contextualizing the implementation and evaluation of national action plans.},
volume = {14},
journal = {Journal of Global Health},
publisher = {International Society of Global Health},
url = {https://doi.org/10.7189/jogh.14.04184},
}
