PADRÃO DE SENSIBILIDADE AOS ANTIMICROBIANOS DE ENTEROBACTERIACEAE ISOLADAS NO HOSPITAL CENTRAL DE MAPUTO, MOÇAMBIQUE 2009–2010

Abstract

Antimicrobial resistance (AR) of many bacterial species is a growing public health problem in many countries. There is scarcity of evidence regarding antibacterial resistance in Mozambique. Thus, the laboratory of Maputo Central Hospital (MCH) introduced in 2009 the WHONET tool for monitoring AR among bacteria isolated from routine clinical specimens. This study describes the antimicrobial susceptibility profile of Enterobacteriaceae isolates from MCH. A descriptive analysis was conducted using data from MCH in WHONET. Enterobacteriaceae isolates from inpatients and outpatients, attended at MCH between October 2009 and October 2010, were tested by Kirby-Bauer disk diffusion method to determine susceptibility to fifteen antibiotics. Data were analyzed using WHONET and Epi-Info. In total, 813 Enterobacteriaceae isolates were identified, the most frequent being Klebsiella spp. (34.7%), Escherichia coli (31.5%) and Proteus spp. (10%). The majority of isolates came from inpatient wards (83.1%), largely from pediatrics (55.5%) and medicine (23.8%) wards. High rates of resistance to antimicrobial agents were observed, principally for amoxycillin (89.7%), ampicillin (89.3%) and amoxycillin/clavulanic acid (73.6%). The proportion of isolates showing drug resistance was significantly greater for inpatient isolates compared to outpatients (p<0.05) for the following antibiotics: amoxycillin, ceftazidime, gentamicin and nitrofurantoin. The result of this analysis shows greater proportions of AR among Enterobacteriaceae isolates and highlights the need to implement suitable surveillance system for AR of bacteria causing infections that are commonly observed in clinical setting like the one in Mozambique.