An Overview of Bacterial Isolates in a Tertiary Hospital in Guyana During 1 Year(2023)
Introduction
The emergence of antimicrobial resistance (AMR) leads to increased patient
morbidity and mortality, along with prolonged hospital stay, decreased patient quality of
life, and increased burden on healthcare infrastructure.
Objectives
To evaluate the prevalence of bacterial isolates obtained in 2023 at the
Georgetown Public Hospital Corporation and analyze their resistance patterns.
Method
This was a descriptive retrospective cross -sectional study that consisted of
extracting data on bacterial cultures from the VITEK 2 system at GPHC obtained from 1st
January 2023 to 31st December 2023. WHONET 2023 was then used to analyze the data to
obtain the prevalence of organisms in the hospital and access their antibiotic resistance
patterns.
Results
A total of 6575 bacterial isolates were obtained, of which 1971 (30%) were gram-
positive organisms which were 33.2%, 30.7% and 28.8% resistant to
trimethoprim/sulfamethoxazole, tetracycline and clindamycin. 4604 (70%) were gram-
negative organisms which were 61.1%, 18.4% and 14.7% resistant to ceftazidime,
piperacillin/tazobactam and imipenem. The prevalence of extended spectrum beta-
lactamase and carbapenem-resistant isolates was 66% and 15.6%. Staphylococcus aureus
(1122 or 59.6%) and Enterococcus species (402 or 20.4%) were the most prevalent gram-
positive organisms while Klebsiella pneumonia and Escherichia coli were the most
prevalent gram-negative isolates (1236 or 26.8% and 1120 or 24.3%).
Conclusion
Better practices in antimicrobial use are needed to combat the high
prevalence and resistance particularly of gram-negative bacteria including ESBL and
carbapenem-resistant isolates.
Recommendations
We recommend the implementation of stricter infection prevention
and control, and antimicrobial stewardship programs including strict monitoring of the
use of reserve antibiotics along with procurement of novel combination antibiotics
reserved for difficult to treat carbapenem-resistant organisms.
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