Original Research

Colonisation with multidrug-resistant organisms among dialysis patients at Universitas Academic Hospital

Godknows Shamhuyashe, Nicoline van Zyl, Cornel van Rooyen, Feziwe Bisiwe, Jolly Musoke
Southern African Journal of Infectious Diseases | Vol 39, No 1 | a607 | DOI: https://doi.org/10.4102/sajid.v39i1.607 | © 2024 Godknows Shamhuyashe, Nicoline van Zyl, Cornel van Rooyen, Feziwe Bisiwe, Jolly Musoke | This work is licensed under CC Attribution 4.0
Submitted: 11 December 2023 | Published: 09 July 2024

About the author(s)

Godknows Shamhuyashe, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
Nicoline van Zyl, Division of Nephrology, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
Cornel van Rooyen, Department of Biostatistics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
Feziwe Bisiwe, Division of Nephrology, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
Jolly Musoke, Department of Medical Microbiology, Universitas Business unit, National Health Laboratory Service, Bloemfontein, South Africa; and Department of Medical Microbiology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa

Abstract

Background: While most infections with multidrug-resistant organisms (MDROs) affect colonised people, there is limited evidence on MDRO colonisation in South African dialysis patients.

Objectives: This study evaluated the prevalence of MDRO colonisation among dialysis patients, the resistance patterns of each MDRO and the risk factors for colonisation.

Method: Rectal and nasal swabs were collected from dialysis patients who consented to participate in a 5-month study to identify selected MDROs (April 2021 – August 2021). Specimens were cultured on selected chromogenic media. Data collected included demographics, clinical information from medical records and laboratory results.

Results: Multidrug-resistant organisms were isolated from 17 (23.9%) of the 71 enrolled participants. Of the 23 MDRO strains from rectal swabs (n = 71), extended-spectrum beta-lactamase-producing Enterobacterales accounted for 21.1% (15/71), vancomycin-resistant enterococci 2.8% (n = 2/71) and carbapenem-resistant Enterobacterales 4.2% (n = 3/71). Klebsiella pneumoniae (65.2%, n = 15/23) was the most prevalent MDRO. More than 80% resistance to trimethoprim and sulfamethoxazole, cefotaxine, and ciprofloxacin was noted. Significant risk factors included previous hospitalisation, proton pump inhibitor use and antibiotic exposure in the past 6 months.

Conclusion: Multidrug-resistant organisms’ carriage was high in our dialysis population. The infection prevention and control measures need to be revised and strengthened.

Contribution: This study falls within the scope of the SAJID journal as it is the first within sub-Sahara Africa to report that approximately one-fifth of dialysis patients were colonised with MDRO, which is a significant risk for MDRO infections.


Keywords

chronic kidney disease; colonisation; dialysis; multidrug-resistant organisms; Universitas Academic Hospital.

Sustainable Development Goal

Goal 3: Good health and well-being

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