TITLE:
Understanding Laboratory Methods and Their Impact on Antimicrobial Resistance Surveillance, at Muhimbili National Hospital, Dar es Salaam, Tanzania
AUTHORS:
Peter Nyasulu, Mabula Kasubi, Respicious Boniface, Jill Murray
KEYWORDS:
Antimicrobial Resistance; Microbiology; Surveillance; Laboratory; Tanzania
JOURNAL NAME:
Advances in Microbiology,
Vol.4 No.1,
January
16,
2014
ABSTRACT: The study sought to describe laboratory methods and blood culture
procedures and their impact on antimicrobial resistance surveillance among
nosocomial bacteria. We conducted a systematic
audit of blood culture procedures and practices in the Department of
Microbiology, Central Pathology Laboratory at Muhimbili National Hospital,
between 19th and 23rd March 2012. A total of 25 -30 blood culture specimens were received each
day as an indication of low volumes of blood
culturing at this site. More blood culture requests came from the neonatal unit
of the hospital, and were performed manually with high culture negative
specimens. The laboratory performed antibiotic susceptibility testing as per
the CLSI guidelines. No vancomycin resistance was ever reported at this site.
All blood culture results were entered into the JEEVA laboratory information
system, where results could be accessed by clinicians in the wards and data
could be retrieved to assess patterns of antimicrobial resistance. Blood
culture data entry system lacked quality control checks hence numerous errors
and missing data were observed. Our results support the relevance of having
improved laboratory procedures and good quality blood culture since
surveillance of antimicrobial resistance primarily depends on good laboratory
procedures, good quality and reliable blood culture data. This would
essentially minimise imprecise estimates of rates of antimicrobial resistance
at this hospital.