{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:19:00Z","timestamp":1788351540589,"version":"build-2803163510"},"reference-count":40,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,14]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Bacterial infections pose a global threat, especially in the pediatric population. Antimicrobials that are used to treat such infections continuously show reduced efficacy, and empirical therapy is a major treatment option in Rwanda. This study aimed to determine the resistance rate of commonly used antibiotics in pediatric patients. The study was conducted from June 1, 2018 to May 30, 2019, and microbiological samples were collected from 712 children with suspected bacterial infections. Antimicrobial sensitivity testing was performed on 177 positive cultures (24%) that were considered for data analysis. The findings show that the major bacterial isolates were <jats:italic>Klebsiella pneumoniae<\/jats:italic> (<jats:italic>n <\/jats:italic>= 50, 28.2%), <jats:italic>Escherichia coli<\/jats:italic> (<jats:italic>n <\/jats:italic>= 47, 26.5%), and <jats:italic>Staphylococcus aureus<\/jats:italic> (<jats:italic>n <\/jats:italic>= 38, 21.4%). In general, the greatest antibiotic resistance rate was observed in ampicillin (<jats:italic>n <\/jats:italic>= 125, 86.2%), amoxicillin\u2013clavulanic acid (<jats:italic>n <\/jats:italic>= 84, 82.4%), amoxicillin (<jats:italic>n <\/jats:italic>= 64, 79%), cefadroxil (<jats:italic>n <\/jats:italic>= 83, 69.2%), tetracycline (<jats:italic>n <\/jats:italic>= 72, 59.7%), ceftazidime (<jats:italic>n <\/jats:italic>= 42, 55.3%), and cefuroxime (<jats:italic>n <\/jats:italic>= 14, 53.8%). More specifically, <jats:italic>Klebsiella pneumoniae<\/jats:italic> was 100% resistant to amoxicillin-clavulanic acid, cefuroxime, trimethoprim\u2013sulfamethoxazole, ceftazidime, erythromycin, and clindamycin. <jats:italic>Staphylococcus aureus was<\/jats:italic> 86.7% resistant to ampicillin, and <jats:italic>Escherichia coli<\/jats:italic> was 91.7% resistant to tetracycline, 90.6% resistant to ampicillin, 83.3% resistant to amoxicillin\u2013clavulanic acid, 79.3% resistant to cefadroxil, and 78.6% resistant to ceftazidime. Moreover, <jats:italic>Klebsiella pneumoniae<\/jats:italic> from blood and urine was 96.8% and 100% sensitive, respectively, to meropenem. <jats:italic>Staphylococcus aureus<\/jats:italic> from blood was 100% sensitive to vancomycin, whereas <jats:italic>Escherichia coli<\/jats:italic> from urine was sensitive to clindamycin (100%), nitrofurantoin (80.6%), and ciprofloxacin (72.7%). In conclusion, our findings show a high resistance rate to commonly used antibiotics, which suggests precaution in empirical therapy and continued surveillance of antimicrobial resistance.<\/jats:p>","DOI":"10.4269\/ajtmh.22-0047","type":"journal-article","created":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T12:49:43Z","timestamp":1665406183000},"page":"1308-1314","source":"Crossref","is-referenced-by-count":11,"title":["Antimicrobial Resistance Profile of Bacteria Causing Pediatric Infections at the University Teaching Hospital in Rwanda"],"prefix":"10.4269","volume":"107","author":[{"given":"Jean Bosco","family":"Munyemana","sequence":"first","affiliation":[{"name":"Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda;"},{"name":"Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bright","family":"Gatare","sequence":"additional","affiliation":[{"name":"Department of Biomedical Laboratory Sciences, Faculty of Allied Fundamental Sciences, INES-Ruhengeri, Ruhengeri, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Kabanyana","sequence":"additional","affiliation":[{"name":"Department of Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Ivang","sequence":"additional","affiliation":[{"name":"Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Djibril","family":"Mbarushimana","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Teaching Hospital of Butare, Butare, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Innocent","family":"Itangishaka","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Teaching Hospital of Butare, Butare, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Damascene","family":"Niringiyumukiza","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, University Teaching Hospital of Butare, Butare, Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emile","family":"Musoni","sequence":"additional","affiliation":[{"name":"Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda;"},{"name":"Department of Pathology, University Teaching Hospital of Kigali, Kigali, Rwanda;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Open Forum Infect Dis","doi-asserted-by":"publisher","first-page":"ofz332","DOI":"10.1093\/ofid\/ofz332","article-title":"Bacteremia in childhood life-threatening infections in urban Gambia: EUCLIDS in West Africa","volume":"6","year":"2019"},{"key":"b2","series-title":"Front Public Health","doi-asserted-by":"publisher","first-page":"612844","DOI":"10.3389\/fpubh.2020.612844","article-title":"Editorial: antimicrobial resistance as a global public health problem: how can we address it?","volume":"8","year":"2020"},{"key":"b3","series-title":"Lancet Infect Dis","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1016\/S1473-3099(13)70318-9","article-title":"Antibiotic resistance: the need for global solutions","volume":"13","year":"2013"},{"key":"b4","series-title":"Zhonghua Xue Ye Xue Za Zhi","first-page":"235","article-title":"Bacterial distribution and drug resistance of pathogens of blood stream infection in children with hematological malignancies after chemotherapy","volume":"40","year":"2019"},{"key":"b5","series-title":"Infect Drug Resist","doi-asserted-by":"publisher","first-page":"2089","DOI":"10.2147\/IDR.S215329","article-title":"Evaluating the antimicrobial resistance patterns among major bacterial pathogens isolated from clinical specimens taken from patients in Mofid Children\u2019s Hospital, Tehran, Iran: 2013\u20132018","volume":"12","year":"2019"},{"key":"b6","series-title":"Ig Sanita Pubbl","first-page":"429","article-title":"Antimicrobial resistance: it is a global crisis, \u201ca slow tsunami\u201d","volume":"75","year":"2019"},{"key":"b7","series-title":"Infect Drug Resist","doi-asserted-by":"publisher","first-page":"699","DOI":"10.2147\/IDR.S299520","article-title":"Bacteriological profile and antimicrobial susceptibility patterns of bloodstream infection at Kigali University Teaching Hospital","volume":"14","year":"2021"},{"key":"b8","series-title":"Microbiol Mol Biol Rev","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1128\/MMBR.00016-10","article-title":"Origins and evolution of antibiotic resistance","volume":"74","year":"2010"},{"key":"b9","series-title":"Drug Discov Today Technol","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.ddtec.2014.02.001","article-title":"General principles of antibiotic resistance in bacteria","volume":"11","year":"2014"},{"key":"b10","series-title":"Microbiol Spectr","first-page":"PMC4888801","article-title":"Mechanisms of antibiotic resistance","volume":"4","year":"2016"},{"key":"b11","series-title":"BMC Gastroenterol","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1186\/s12876-020-01201-6","article-title":"Use of microbiological and patient data for choice of empirical antibiotic therapy in acute cholangitis","volume":"20","year":"2020"},{"key":"b12","series-title":"Medicine (Baltimore)","doi-asserted-by":"publisher","first-page":"e15101","DOI":"10.1097\/MD.0000000000015101","article-title":"Utility of point-of-care Gram stain by physicians for urinary tract infection in children \u2264 36 months","volume":"98","year":"2019"},{"key":"b13","series-title":"Lancet Infect Dis","doi-asserted-by":"publisher","first-page":"e33","DOI":"10.1016\/S1473-3099(17)30467-X","article-title":"Antimicrobial resistance among children in sub-Saharan Africa","volume":"18","year":"2018"},{"key":"b14","series-title":"Lancet Infect Dis","doi-asserted-by":"publisher","first-page":"1677","DOI":"10.1016\/S1473-3099(21)00050-5","article-title":"Effects of antibiotic resistance, drug target attainment, bacterial pathogenicity and virulence, and antibiotic access and affordability on outcomes in neonatal sepsis: an international microbiology and drug evaluation prospective substudy (BARNARDS)","volume":"21","year":"2021"},{"key":"b15","series-title":"Antibiotics (Basel)","first-page":"PMC7915286","article-title":"An evaluation of antibiotic prescribing practices in a rural refugee settlement district in Uganda","volume":"10","year":"2021"},{"key":"b16","series-title":"J Glob Antimicrob Resist.","article-title":"Empirical fluoroquinolones versus broad-spectrum beta-lactams for Gram-Negative bloodstream infections in the absence of antimicrobial resistance risk factors","year":"2019"},{"key":"b17","series-title":"BMJ","first-page":"i939","article-title":"Global prevalence of antibiotic resistance in paediatric urinary tract infections caused by Escherichia coli and association with routine use of antibiotics in primary care: systematic review and meta-analysis","volume":"352","year":"2016"},{"key":"b18","series-title":"J Clin Med Res","doi-asserted-by":"publisher","first-page":"635","DOI":"10.14740\/jocmr3928","article-title":"Change in the antimicrobial resistance profile of extended-spectrum beta-lactamase-producing Escherichia coli.","volume":"11","year":"2019"},{"key":"b19","series-title":"Heliyon","doi-asserted-by":"publisher","first-page":"e02956","DOI":"10.1016\/j.heliyon.2019.e02956","article-title":"Bacteriological profile and antimicrobial resistance patterns of burn wound infections in a tertiary care hospital","volume":"5","year":"2019"},{"key":"b20","series-title":"Am J Trop Med Hyg","doi-asserted-by":"publisher","first-page":"865","DOI":"10.4269\/ajtmh.14-0607","article-title":"High prevalence of antimicrobial resistance among common bacterial isolates in a tertiary healthcare facility in Rwanda","volume":"92","year":"2015"},{"key":"b21","series-title":"JCI Insight.","article-title":"Host immunology and rational immunotherapy for carbapenem-resistant Klebsiella pneumoniae infection","year":"2020"},{"key":"b22","series-title":"J Pediatr (Rio J)","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.jped.2019.10.006","article-title":"Urinary tract infection in pediatrics: an overview","volume":"96","year":"2020"},{"key":"b23","series-title":"Infect Dis Rep","doi-asserted-by":"publisher","first-page":"26","DOI":"10.3390\/idr14010004","article-title":"Bacterial species and antimicrobial resistance of clinical isolates from pediatric patients in Yangon, Myanmar, 2020","volume":"14","year":"2022"},{"key":"b24","series-title":"Infect Dis (Auckl)","first-page":"1178633720909798","article-title":"Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella species in pediatric patients visiting International Friendship Children\u2019s Hospital, Kathmandu, Nepal","volume":"13","year":"2020"},{"key":"b25","series-title":"BMC Pediatr","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s12887-019-1411-0","article-title":"Deciphering risk factors for blood stream infections, bacteria species and antimicrobial resistance profiles among children under five years of age in north-western Tanzania: a multicentre study in a cascade of referral health care system","volume":"19","year":"2019"},{"key":"b26","series-title":"Foodborne Pathog Dis","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1089\/fpd.2010.0787","article-title":"Global monitoring of Salmonella serovar distribution from the World Health Organization Global Foodborne Infections Network Country Data Bank: results of quality assured laboratories from 2001 to 2007","volume":"8","year":"2011"},{"key":"b27","series-title":"BMC Public Health","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1186\/s12889-018-6013-5","article-title":"Antimicrobial resistance of pathogens causing nosocomial bloodstream infection in Hubei Province, China, from 2014 to 2016: a multicenter retrospective study","volume":"18","year":"2018"},{"key":"b28","series-title":"J Hosp Infect","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1016\/j.jhin.2020.11.028","article-title":"Nosocomial infection by Klebsiella pneumoniae among neonates: a molecular epidemiological study","volume":"108","year":"2021"},{"key":"b29","series-title":"Ann Clin Microbiol Antimicrob","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s12941-019-0334-9","article-title":"Systematic review of carbapenem-resistant Enterobacteriaceae causing neonatal sepsis in China","volume":"18","year":"2019"},{"key":"b30","series-title":"Medicine (Baltimore)","doi-asserted-by":"publisher","first-page":"e27186","DOI":"10.1097\/MD.0000000000027186","article-title":"Factors behind the prevalence of carbapenem-resistant Klebsiella pneumoniae in pediatric wards","volume":"100","year":"2021"},{"key":"b31","series-title":"Antimicrob Resist Infect Control","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1186\/s13756-018-0411-4","article-title":"Antibiotic resistance, virulence factors and genotyping of uropathogenic Escherichia coli strains","volume":"7","year":"2018"},{"key":"b32","series-title":"Int J Antimicrob Agents","doi-asserted-by":"publisher","first-page":"105833","DOI":"10.1016\/j.ijantimicag.2019.10.014","article-title":"A systematic review and meta-analysis of treatment outcomes following antibiotic therapy among patients with carbapenem-resistant Klebsiella pneumoniae infections","volume":"55","year":"2020"},{"key":"b33","series-title":"J Taibah Univ Med Sci","first-page":"39","article-title":"Pattern of bacterial profile and antibiotic susceptibility among neonatal sepsis cases at Cairo University Children Hospital","volume":"15","year":"2020"},{"key":"b34","series-title":"Arch Dis Child","first-page":"113","article-title":"Clinical efficacy of co-trimoxazole versus amoxicillin twice daily for treatment of pneumonia: a randomised controlled clinical trial in Pakistan","volume":"86","year":"2002"},{"key":"b35","series-title":"PLoS One","doi-asserted-by":"publisher","first-page":"e0221121","DOI":"10.1371\/journal.pone.0221121","article-title":"Widespread antimicrobial resistance among bacterial infections in a Rwandan referral hospital","volume":"14","year":"2019"},{"key":"b36","series-title":"Sci Rep","doi-asserted-by":"publisher","first-page":"9788","DOI":"10.1038\/s41598-019-46078-y","article-title":"Antibiotic drug-resistance as a complex system driven by socio-economic growth and antibiotic misuse","volume":"9","year":"2019"},{"key":"b37","series-title":"Pan Afr Med J","first-page":"276","article-title":"Antibiotic susceptibility of community-acquired strains of Staphylococcus aureus in Nouakchott region (Mauritania)","volume":"24","year":"2016"},{"key":"b38","series-title":"Can J Infect Dis","first-page":"215","article-title":"Imipenem and meropenem: comparison of in\u00a0vitro activity, pharmacokinetics, clinical trials and adverse effects","volume":"9","year":"1998"},{"key":"b39","series-title":"Yale J Biol Med","first-page":"269","article-title":"Vancomycin resistance in Staphylococcus aureus.","volume":"90","year":"2017"},{"key":"b40","series-title":"Pediatr Infect Dis J","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1097\/INF.0000000000002992","article-title":"Reduced vancomycin susceptibility, MRSA and treatment failure in pediatric Staphylococcus aureus bloodstream infections","volume":"40","year":"2021"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/107\/6\/article-p1308.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/107\/6\/article-p1308.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/107\/6\/article-p1308.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T19:06:17Z","timestamp":1675710377000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/107\/6\/article-p1308.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,14]]},"references-count":40,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.22-0047","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,14]]}}}