ArticlePloS one2019
Widespread antimicrobial resistance among bacterial infections in a Rwandan referral hospital.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Third-Generation Cephalosporin-Resistant Enterobacterales and Methicillin-ResistantAnimals : an open access journal from MDPI · 2025Article
- ePOCT+ Rwanda: A Clinical Decision Support Algorithm For Managing Sick Children Below 15 Years of Age in Primary Healthcare Settings.Rwanda journal of medicine and health sciences · 2025Article
- Bedside inoculation accelerates detection and improves microbiological diagnosis efficiency compared to delayed inoculation.American journal of translational research · 2025Article
- Multidrug-resistant bacterial infections and their clinical impact at the University Teaching Hospital of Kigali in Rwanda: a retrospective descriptive-analytical study.Frontiers in public health · 2025Article
- Diversity, Distribution, and Resistance Profiles of Bacterial Bloodstream Infections in Three Tertiary Referral Hospitals in Rwanda Between 2020 and 2022.Antibiotics (Basel, Switzerland) · 2024Article
- Knowledge, Attitude, and Practices of Antibiotic Usage and Resistance among People Attending Primary Healthcare in Rwanda.Rwanda journal of medicine and health sciences · 2024Article
- Prescription Practices and Usage of Antimicrobials in a Tertiary Teaching Hospital in Rwanda: A Call for Antimicrobial Stewardship.Antibiotics (Basel, Switzerland) · 2024Article
- The prevalence and clinical context of antimicrobial resistance amongst medical inpatients at a referral hospital in Rwanda: a cohort study.Antimicrobial resistance and infection control · 2024Article
- Social and ecological determinants of antimicrobial resistance in Africa: a systematic review of epidemiological evidence.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Review
- Phenotypic and Genotypic Characterization of Extended Spectrum Beta-Lactamase-Producing Clinical Isolates ofInternational journal of microbiology · 2024Article
- Antimicrobial Resistance in Papua New Guinea: A Narrative Scoping Review.Antibiotics (Basel, Switzerland) · 2023Article
- Antimicrobial Resistance Profile of Bacteria Causing Pediatric Infections at the University Teaching Hospital in Rwanda.The American journal of tropical medicine and hygiene · 2022Article
- Burden of Antibiotic Resistance at Wolaita Sodo University Comprehensive Specialized Hospital.BioMed research international · 2022Article
- New threatening of SARS-CoV-2 coinfection and strategies to fight the current pandemic.Medicine in drug discovery · 2021Review
- Antibiotic-ResistantAnimals : an open access journal from MDPI · 2021Article
- Predicting mortality in adults with suspected infection in a Rwandan hospital: an evaluation of the adapted MEWS, qSOFA and UVA scores.BMJ open · 2021Article
- Sepsis in two hospitals in Rwanda: A retrospective cohort study of presentation, management, outcomes, and predictors of mortality.PloS one · 2021Article
- Strengthening Antimicrobial Resistance Diagnostic Capacity in Rural Rwanda: A Feasibility Assessment.Annals of global health · 2021Article
- Surgical Site Infections and Antimicrobial Resistance After Cesarean Section Delivery in Rural Rwanda.Annals of global health · 2021Article
- Antimicrobial Resistance inFrontiers in medicine · 2021Review
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Authors and funding
13 authors.
Funding
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Abstract
backgroundResistance among bacterial infections is increasingly well-documented in high-income countries; however, relatively little is known about bacterial antimicrobial resistance in low-income countries, where the burden of infections is high.
methodsWe prospectively screened all adult inpatients at a referral hospital in Rwanda for suspected infection for seven months. Blood, urine, wound and sputum samples were cultured and tested for antibiotic susceptibility. We examined factors associated with resistance and compared hospital outcomes for participants with and without resistant isolates.
resultsWe screened 19,178 patient-days, and enrolled 647 unique participants with suspected infection. We obtained 942 culture specimens, of which 357 were culture-positive specimens. Of these positive specimens, 155 (43.4%) were wound, 83 (23.2%) urine, 64 (17.9%) blood, and 55 (15.4%) sputum. Gram-negative bacteria comprised 323 (88.7%) of all isolates. Of 241 Gram-negative isolates tested for ceftriaxone, 183 (75.9%) were resistant. Of 92 Gram-negative isolates tested for the extended spectrum beta-lactamase (ESBL) positive phenotype, 66 (71.7%) were ESBL positive phenotype. Transfer from another facility, recent surgery or antibiotic exposure, and hospital-acquired infection were each associated with resistance. Mortality was 19.6% for all enrolled participants.
conclusionsThis is the first published prospective hospital-wide antibiogram of multiple specimen types from East Africa with ESBL testing. Our study suggests that low-resource settings with limited and inconsistent access to the full range of antibiotic classes may bear the highest burden of resistant infections. Hospital-acquired infections and recent antibiotic exposure are associated with a high proportion of resistant infections. Efforts to slow the development of resistance and supply effective antibiotics are urgently needed.
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