Abstract:
In order to determine the patterns and antimicrobial susceptibility of
bacterial isolate causing pyogenic infections, a cross sectional study was
done at the Muhimbili National Hospital, Dar. es Salaam from 1St to 31st
of September, 1999. Consecutive 209 pus isolates from infected
umbilical cord stumps, wounds, post-surgery wounds, ears, eyes and
abscesses were collected. The pattern and causative agents of superficial
pyogenic infections, characteristics of patients by age and sex,
antimicrobial susceptibility patterns of the isolates, comparison of
resistance patterns among inpatients and outpatients and relation
between antibiotic use and susceptibility patterns were studied.
S. aureus was the commonest isolate (22.5%), of which 87.2% and 2.1%
were resistant to penicillin, and methicillin respectively. Among the
Gram-negative rods, Proteus spp was the most prevalent isolate (12.4%).
A significant proportion of Gram-negative bacteria was resistant to
ampicillin, doxycycline, amoxycillin/ clavulanic acid and
chloramphenicol. Pseudomonads were sensitive to all antimicrobials
tested. There was no influence of age, sex or patient status in the
distribution of the antimicrobial resistant isolates.
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The relationship between antimicrobial utilization and resistance was
not clearly demonstrated. The resistance to erythromycin among
S.aureus had increased from 2% in 1979 to 34% in the present study,
while tetracycline resistance among S.aureus declined from 44% in 1978
to 29.8% in the current study. It was recommended that ampicilin and
penicillin should not be used in staphylococcal infections,
while tetracycline, trimethoprim/ sulphamethaxazole, amoxycilin/
clavulanic acid and erythromycin should be used cautiously basing on
sensitivity testing. There is a need to establish a surveillance system to
monitor antimicrobial resistance.
