Evidence map›Paper›PMID 32535645›Full record

Observational studyWorld journal of surgery2020

Community- and Hospital-Acquired Infections in Surgical patients at a Tertiary Referral Hospital in Rwanda.

Vital Muvunyi, Christophe Mpirimbanyi, Jean Bosco Katabogama, Thierry Cyuzuzo, Theoneste Nkubana, Jean Baptiste Mugema, Emile Musoni, Christian Urimubabo, Jennifer Rickard

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in World journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Clinical, microbiological, and prognostic differences between hypermucoviscous and non-hypermucoviscous community-acquired Klebsiella pneumoniae infections.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025
    Article
  5. Article
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Vital MuvunyiDepartment of Surgery, University of Rwanda, Kigali, Rwanda.
Christophe MpirimbanyiDepartment of Surgery, University of Rwanda, Kigali, Rwanda.
Jean Bosco KatabogamaDepartment of Surgery, University of Rwanda, Kigali, Rwanda.
Thierry CyuzuzoDepartment of Surgery, University of Rwanda, Kigali, Rwanda.
Theoneste NkubanaClinical Laboratory, University Teaching Hospital of Kigali, Kigali, Rwanda.
Jean Baptiste MugemaClinical Laboratory, University Teaching Hospital of Kigali, Kigali, Rwanda.
Emile MusoniClinical Laboratory, University Teaching Hospital of Kigali, Kigali, Rwanda.
Christian UrimubaboDepartment of Surgery, University Teaching Hospital of Kigali, Kigali, Rwanda.
Jennifer RickardDepartment of Surgery, University of Rwanda, Kigali, Rwanda. gehr0059@umn.edu.
University of Kigali · RWUniversity of Rwanda · RWCentre Hospitalier Universitaire de Kigali · RW

Funding

University of Minnesota Clinical and Translational Science Institute (UMN CTSI)UL1TR002494 · NCATS · UNIVERSITY OF MINNESOTA · PI BLAZAR, BRUCE R, WEISDORF, DANIEL J · 2018 to 2022
$34.9M
NCATS NIH HHS UL1 TR002494
6 · The paper itself

Abstract

backgroundExtended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) are increasing in globally. The aim of this study was to compare community-acquired infections (CAIs) and hospital-acquired infections (HAIs) and determine the rate of third-generation cephalosporin resistance and ESBL-PE at a tertiary referral hospital in Rwanda.

methodsThis was a cross-sectional study of Rwandan acute care surgery patients with infection. Samples were processed for culture and susceptibility patterns using Kirby-Bauer disk diffusion method. Third-generation cephalosporin resistance and ESBL-PE were compared in patients with CAI versus HAI.

resultsOver 14 months, 220 samples were collected from 191 patients: 116 (62%) patients had CAI, 59 (32%) had HAI, and 12 (6%) had both CAI and HAI. Most (n = 178, 94%) patients were started on antibiotics with third-generation cephalosporins (ceftriaxone n = 109, 57%; cefotaxime n = 52, 27%) and metronidazole (n = 155, 81%) commonly given. Commonly isolated organisms included Escherichia coli (n = 62, 42%), Staphylococcus aureus (n = 27, 18%), and Klebsiella spp. (n = 22, 15%). Overall, 67 of 113 isolates tested had resistance to third-generation cephalosporins, with higher resistance seen in HAI compared with CAI (74% vs 46%, p value = 0.002). Overall, 47 of 89 (53%) isolates were ESBL-PE with higher rates in HAI compared with CAI (73% vs 38%, p value = 0.001).

conclusionsThere is broad and prolonged use of third-generation cephalosporins despite high resistance rates. ESBL-PE are high in Rwandan surgical patients with higher rates in HAI compared with CAIs. Infection prevention practices and antibiotic stewardship are critical to reduce infection rates with resistant organisms in a low-resource setting.

Indexed as

AdultCommunity-Acquired InfectionsCross InfectionCross-Sectional StudiesDrug Resistance, BacterialEnterobacteriaceae InfectionsEscherichia coliFemaleHumansMaleMiddle AgedStaphylococcus aureusTertiary Care Centers

Identifiers

PMID32535645
OpenAlexW3035408083

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.