Abstract:
Background: Antibiotic resistance poses burden to the community and health-care services.
Efforts are being made at local, national and global level to combat the rise of antibiotic
resistance including antibiotic stewardship. Surveillance to antibiotic resistance is of impor tance to aid in planning and implementing infection prevention and control measures. The
study was conducted to assess the resistance pattern to cefepime, clindamycin and merope nem, which are reserved antibiotics for use at tertiary hospitals in Tanzania.
Methods: A hospital-based antibiotic resistance surveillance was conducted between July
and November 2019 at Muhimbili National Hospital and Bugando Medical Center, Tanzania.
All organisms isolated were identified based on colony morphology, Gram staining and
relevant biochemical tests. Antibiotic susceptibility testing was performed on Muller-Hinton
agar using Kirby-Bauer disc diffusion method. Antibiotic susceptibility was performed
according to the protocol by National Committee for Clinical Laboratory Standards.
Results: A total of 201 clinical samples were tested in this study. Urine (39.8%, n=80) and
blood (35.3%, n=71) accounted for most of the collected samples followed by pus (16.9%,
n=34). The bacterial resistance to clindamycin, cefepime and meropenem was 68.9%, 73.2%
and 8.5%, respectively. About 68.4% Staphylococcus aureus isolates were resistant to
clindamycin whereby 56.3%, 75.6%, 93.8% and 100% of the tested Escherichia coli,
Klebsiella spp, Pseudomonas aeruginosa and Enterobacter cloacae, respectively, were
cefepime resistant. About 8.5% of isolated Klebsiella spp were resistant and 6.4% had
intermediate susceptibility to meropenem. Also, Pseudomonas aeruginosa was resistant by
31.2% and 25% had intermediate susceptibility to meropenem.
Conclusion: The bacterial resistance to clindamycin and cefepime is high and low in
meropenem. Henceforth, culture and susceptibility results should be used to guide the use
of these antibiotics. Antibiotics with low resistance rate should be introduced to the reserve
category and continuous antibiotic surveillance is warranted
