Anti-bacterial resistance patterns and trends among septicaemic patients in Kampala, Uganda, 2010-2015

Introduction : bacterial infections cause 20% of hospital deaths and 25% of under-five mortality in Uganda. We analyzed laboratory data on antibiotic resistance (ABR) patterns in Kampala, Uganda, to inform interventions to reduce ABR. Methods : we abstracted culture and sensitivity data from 10 laboratory registers for all blood specimens cultured from 2010-2015 using a standardized data abstraction form. We defined high ABR as ≥50% of species resistant to a drug in a year; moderate ABR as 10-49% resistant; low as Results : among gram-positive species, Staphylococcus accounted for 86% (1541/1794) of the infections; under-five (incidence = 218/100,000) and elderly (incidence = 125/100,000) age-groups were most affected. Of gram-negative species, Salmonella accounted for 21% (251/1193) of the infections; the age-specific incidence (/100,000) ranged from 7 (young adults age-group) to 17(under-fives). Non-specified coliforms were identified in 28% of the isolates. 11% of the Staphylococcal species had moderate ABR and 89% had high ABR to commonly used antibiotics (CAF, CTX, Erythromycin, Tetracycline). Over the six-year study period, MRSA increased from 44% to 81% (p=0.03, Chi-square for trends); among Salmonella species, ABR to first-line antibiotics reduced from high to moderate levels; MDR Salmonella ranged from 0-20%; intermediate resistance levels to Ciprofloxacin increased from 2% to 39% (p Conclusion : salmonella and staphylococcus were the most common causes of septicaemia. MRSA was at a high level, with rapidly increasing ABR to Ciprofloxacin and Ceftriaxone. Susceptibility to first-line antibiotics among Salmonella species gradually returned. We recommend adherence to ABR testing standards and rational use of antibiotics guided by ABR patterns to prevent ABR.