Antimicrobial resistance in hospitalized surgical patients: a silently emerging public health concern in Benin

Abstract Background Surgical site infections are related to high morbidity, mortality and healthcare costs. Because the emergence of multidrug-resistant bacteria in hospitals is becoming a worldwide challenge for surgeons who treat healthcare-associated infections, we wished to identify the causativ...

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Bibliographic Details
Published in:Annals of clinical microbiology and antimicrobials 2020-11, Vol.19 (1), p.1-54, Article 54
Main Authors: Yehouenou, Carine Laurence, Kpangon, Arsène A, Affolabi, Dissou, Rodriguez-Villalobos, Hector, Van Bambeke, Françoise, Dalleur, Olivia, Simon, Anne
Format: Article
Language:English
Subjects:
Aerobic bacteria
Antibiotics
Antimicrobial agents
Antimicrobial resistance
Bacteria
Beta lactamases
Cefepime
Ceftazidime
Ceftriaxone
Clindamycin
Data collection
Diagnostic systems
Disease control
Drug resistance
Drug resistance in microorganisms
E coli
Gram-negative bacteria
Gram-positive bacteria
Health aspects
Health care
High resistance
Hospital patients
Hospitals
Hygiene
Infection
Infections
Laboratories
Lactose
Mass spectrometry
Mass spectroscopy
Medical care
Medical care, Cost of
Methicillin
Microbiology
Morbidity
Mortality
Multidrug resistance
Multidrug resistant organisms
Nosocomial infections
Obstetrics
Pathogens
Patients
Personal hygiene
Phenotypes
Prevalence studies (Epidemiology)
Public health
Quality control
Quality management
Questionnaires
Staphylococcus aureus
Staphylococcus aureus infections
Staphylococcus infections
Surgeons
Surgery
Surgical site infections
Surveillance
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Summary:Abstract Background Surgical site infections are related to high morbidity, mortality and healthcare costs. Because the emergence of multidrug-resistant bacteria in hospitals is becoming a worldwide challenge for surgeons who treat healthcare-associated infections, we wished to identify the causative agents involved in these infections and the rate of multidrug-resistant bacteria in six public hospitals in Benin. Methods Using standard microbiological procedures, we processed pus specimens collected from obstetrics and gastrointestinal surgery wards. Mass spectrometry (MALDI-TOF) was used for confirmation. For the antibiotic susceptibility test, we first used the Kirby-Bauer disk diffusion method. The secondary test (by microdilution) used the Beckton Dickinson Phoenix automated system (Becton Dickinson Diagnostic, USA). Results We included 304 patients, whose median length of stay was 9 days. A total of 259 wound swabs (85.2%) had positive aerobic bacterial growth. In obstetrics, S. aureus (28.5%, n = 42) was the most common isolate. In contrast, Gram-negative bacteria (GNB) were predominant in gastrointestinal surgery, the most dominant being E.coli (38.4%, n = 31). Overall, 90.8% (n = 208) of aerobic bacteria were multidrug resistant. Two-thirds of S. aureus (65.3%, n = 32) were methicillin-resistant Staphylococcus aureus (MRSA), three of which carried both MRSA and induced clindamycin resistance (ICR). GNB showed high resistance to ceftazidime, ceftriaxone and cefepime. Extended-spectrum beta-lactamases were presented by 69.4% of E.coli (n = 43/62) and 83.3% of K. pneumoniae (n = 25/30). Overall, twelve Gram-negative bacteria (5.24%) showed resistance to at least one carbapenem. No isolates showed a wild-type susceptible phenotype. Conclusion This study shows the alarming prevalence of multidrug-resistant organisms from surgical site infections in Benin hospitals. To reduce the spread of such bacteria in Benin, periodic surveillance of surgical site infections and strict adherence to good hand-hygiene practice are essential.
ISSN:1476-0711
1476-0711
DOI:10.1186/s12941-020-00398-4