Drivers of antimicrobial resistance in Uganda and Malawi
Antimicrobial resistance is predicted to impact most heavily on sub-Saharan Africa, however there remains a lack of clinical outcome data from drug-resistant infections in this setting.
We have recruited a series of prospective longitudinal cohorts from Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi and the surrounding communities to describe the aetiology of febrile illness, the burden of AMR and the distribution of extended spectrum beta-lactamase producing bacteria in humans, animals and the environment. Life threatening febrile illness common in Blantyre however, diagnostics are few and current antibiotic usage therefore rational. We are, however frequently treating the wrong bugs with ceftriaxone, which is promoting carriage of ESBL bacteria out of the hospital and ESBL E. coli and K. pneumoniae are ubiquitous in the community, where environmental hygiene infrastructure and community antimicrobial stewardship are critically lacking.
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Professor Nick Feasey, Liverpool School of Tropical Medicine and University of St Andrews
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