Surveillance of antimicrobial resistance at a tertiary hospital in Tanzania

BACKGROUND: Antimicrobial resistance is particularly harmful to infectious disease management in low-income countries since expensive second-line drugs are not readily available. The objective of this study was to implement and evaluate a computerized system for surveillance of antimicrobial resistance at a tertiary hospital in Tanzania. METHODS: A computerized surveillance system for antimicrobial susceptibility (WHONET) was implemented at the national referral hospital in Tanzania in 1998. The antimicrobial susceptibilities of all clinical bacterial isolates received during an 18 months' period were recorded and analyzed. RESULTS: The surveillance system was successfully implemented at the hospital. This activity increased the focus on antimicrobial resistance issues and on laboratory quality assurance issues. The study identified specific nosocomial problems in the hospital and led to the initiation of other prospective studies on prevalence and antimicrobial susceptibility of bacterial infections. Furthermore, the study provided useful data on antimicrobial patterns in bacterial isolates from the hospital. Gram-negative bacteria displayed high rates of resistance to common inexpensive antibiotics such as ampicillin, tetracycline and trimethoprim-sulfamethoxazole, leaving fluoroquinolones as the only reliable oral drugs against common Gram-negative bacilli. Gentamicin and third generation cephalosporins remain useful for parenteral therapy. CONCLUSION: The surveillance system is a low-cost tool to generate valuable information on antimicrobial resistance, which can be used to prepare locally applicable recommendations on antimicrobial use. The system pinpoints relevant nosocomial problems and can be used to efficiently plan further research. The surveillance system also functions as a quality assurance tool, bringing attention to methodological issues in identification and susceptibility testing

Microbial Quality of Traditional Alcoholic Beverages Consumed in Dar es Salaam, Tanzania

Three traditional alcoholic beverages available locally in Dar es Salaam namely ‘mbege', ‘mnazi' and ‘komoni' were subjected to microbiological assessments in order to determine their microbial quality and possible resistance to antibiotics among the isolated microorganisms. Twenty-seven samples were randomly collected from local drinking clubs in all the three districts included in the study. The microorganisms were isolated and identified by the conventional methods. Microbial counts were determined for the beverages. The total viable yeast counts in ‘mbege', ‘mnazi' and ‘komoni' were 2.37 x 1016, 3.9 x 1016 and 7.0 x 1010 cfu/ml respectively, while the total viable counts for bacteria in the same beverages were 9.50 x 109, 2.22 x 1010 and 1.88 x 1010 cfu/ml respectively. Antimicrobial sensitivity tests on the microorganisms showed that all bacteria were susceptible to a majority of the assayed antibacterials, whilst yeasts were resistant to all the antifungal agents tested except clotrimazole. The results indicate that these beverages pose a danger to public health due to the observed high ‘bio-burden' and call for better and safer means for the preparation, processing and handling of the products. . Keywords: Traditional beverages, microorganisms, antibacterials, antifungal agents. The East and Central African Journal of Pharmaceutical Sciences Vol. 8 (3) 2005: pp 8-1