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. 2020 Jun 12:5:140.
doi: 10.12688/wellcomeopenres.15977.1. eCollection 2020.

Antimicrobial Resistance in Gram-negative bacteria from Urinary Specimens: a study of prevalence, risk factors and molecular mechanisms of resistance (ARGUS) in Zimbabwe - a study protocol

Ioana D Olaru  1   2 , Shunmay Yeung  1 , Rashida A Ferrand  1   2 , Richard Stabler  1 , Prosper Chonzi  3 , David Mabey  1 , Heidi Hopkins  1 , John Bradley  1 , Kudzai P E Masunda  3 , Shungu Munyati  2 , Katharina Kranzer  1   2
Affiliations

Antimicrobial Resistance in Gram-negative bacteria from Urinary Specimens: a study of prevalence, risk factors and molecular mechanisms of resistance (ARGUS) in Zimbabwe - a study protocol

Ioana D Olaru et al. Wellcome Open Res. .

Abstract

Antimicrobial resistance (AMR) is compromising our ability to successfully treat infections. There are few data on gram-negative AMR prevalence in sub-Saharan Africa especially from the outpatient setting. This study aims to investigate the prevalence of and underlying molecular mechanisms for AMR in gram-negative bacilli causing urinary tract infections (UTIs) in Zimbabwe. Risk factors for AMR and how AMR impacts on clinical outcomes will also be investigated. Adults presenting with UTI symptoms at primary health clinics in Harare will be included. A questionnaire will be administered, and urine samples will be collected for culture. Participants with positive urine cultures will be followed up at 7-14 days post-enrolment. All participants will also be followed by telephone at 28 days to determine clinical outcomes. Bacterial identification and antibiotic susceptibility testing will be performed on positive cultures. The results from this study will be used to inform policy and development of treatment recommendations. Whole genome sequencing results will provide a better understanding of the prevalent resistance genes in Zimbabwe, of the spread of successful clones, and potentially will contribute to developing strategies to tackle AMR.

Keywords: AMR; Escherichia coli; antibiotic resistance.

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Conflict of interest statement

No competing interests were disclosed.

Figures

Figure 1.
Figure 1.. Studies from sub-Saharan Africa and prevalence of third-generation cephalosporin resistance in E. coli and K. pneumoniae.
Only studies describing antimicrobial resistance prevalence in isolates from blood or urine cultures are included. The numbers in the small boxes represent the number of isolates with a reported third-generation cephalosporin test result. The orange bars in the graphs represent the proportion of isolates with third-generation cephalosporin resistance for E. coli (left) and K. pneumoniae (right). The white bars represent the proportion of susceptible isolates. The shaded boxes at the bottom of the picture represent the number of studies according to country. EC: Escherichia coli; KP: Klebsiella pneumoniae. One study presented data from multiple countries and was not included on the map. This figure was compiled using the studies listed in Table 1.
Figure 2.
Figure 2.. Outline of procedures at enrolment and follow-up.
UTI: urinary tract infection, Abx: antibiotics.
Figure 3.
Figure 3.. Evaluation of causes for negative urine cultures.
STI: sexually transmitted infections; CT: Chlamydia trachomatis; NG: Neisseria gonorrhoeae; TV: Trichomonas vaginalis.
See this image and copyright information in PMC

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