Wounds, Antimicrobial Resistance and Challenges of Implementing a Surveillance System in Myanmar: A Mixed-Methods Study

Wound infections with drug-resistant bacteria lead to higher mortality and morbidity and increased healthcare costs. We aimed to describe the spectrum of bacterial pathogens, isolated from wound cultures in Yangon General Hospital in 2018, and their antimicrobial resistance (AMR) patterns and to und...

Full description

Saved in:
Bibliographic Details
Published in:Tropical medicine and infectious disease 2021-05, Vol.6 (2), p.80
Main Authors: Sandar, Win-Pa, Saw, Saw, Kumar, Ajay M. V., Camara, Bienvenu Salim, Sein, Myint-Myint
Format: Article
Language:English
Subjects:
AMR surveillance
Antibiotics
Antimicrobial agents
antimicrobials
Bacteria
Data collection
Developing countries
Drug resistance
Expenditures
GLASS
Health facilities
Hospitals
Infections
Interviews
Laboratories
LDCs
Mixed methods research
operational research
Pathogens
Rural health care
SORT IT
Surveillance
Working groups
wound infection
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Wound infections with drug-resistant bacteria lead to higher mortality and morbidity and increased healthcare costs. We aimed to describe the spectrum of bacterial pathogens, isolated from wound cultures in Yangon General Hospital in 2018, and their antimicrobial resistance (AMR) patterns and to understand the challenges in implementing an AMR surveillance system in Myanmar. We conducted a concurrent mixed-methods study involving analysis of surveillance data and in-depth interviews with nine key personnel involved in AMR surveillance. Of 1418 wound specimens processed, 822 (58%) were culture-positive. The most common Gram-positive bacteria were coagulase-negative staphylococci (23.3%) and Staphylococcus aureus (15.1%). Among Gram-negative bacteria, Escherichia coli (12.5%) and Pseudomonas aeruginosa (10.1%) were common. Staphylococcus aureus isolates were resistant to penicillin (98%), oxacillin (70%) and tetracycline (66%). Escherichia coli showed resistance to ampicillin (98%). Lack of dedicated and trained staff (microbiologist, technician, data entry operator), lack of computers at sentinel sites and non-uniform and non-standardized data capture formats were the major challenges in implementing AMR surveillance. These challenges need to be addressed urgently. We also recommend periodic analysis and sharing of antibiograms at every hospital to inform the treatment regimens used in wound management.
ISSN:2414-6366
2414-6366
DOI:10.3390/tropicalmed6020080