Molecular Mechanism Research

Antimicrobial Resistance Status Among Referred Patients Attending at Nova Diagnostic and Research in Mogadishu, Somalia

Abdullahi Tukade

NOVA Diagnostic and Research, Mogadishu, Somalia, shabeeldhaka1@gmail.com

Hassan MohamudDirie

Royal Hospital, Mogadishu, Somalia, mr.xm18@gmail.com

Marian OmarOsman

NOVA Diagnostic and Research, Mogadishu, Somalia, mariaomar2825@gmail.com

Kassim HagiHossain

Jazeera University Medical College, Mogadishu, Somalia, doctorqaasim@gmail.com

Md BiplobHossain

NOVA Diagnostic and Research, Mogadishu, Somalia, biplobali17@gmail.com

Abdirahim Ahmed

NOVA Diagnostic and Research, Mogadishu, Somalia, abdirahim@nova.com

Chomel Mahbub

BIHS General Hospital, Dhaka, Bangladesh, chomel60@gmail.com

Afrin Haque

BIHS General Hospital, Dhaka, Bangladesh, afrinhaque95@gmail.com

Md. AshiqurRahman

Novus Clinical Research Services Limited, Dhaka, Bangladesh, ararashiqur@gmail.com

Sadia Islam

Bangladesh Specialized Hospital PLC, Bangladesh, sadia.buhs.6700@gmail.com

DOI: https://doi.org/mmr.v2i2.7856

Keywords: Bacterial infection; antimicrobial resistance; gram negative bacteria; bacterial isolates; disc diffusion technique

---

Abstract

Bacterial infections remain a major global health concern, contributing significantly to morbidity and mortality. While antimicrobials have been effective in treating these infections, the rising threat of antimicrobial resistance (AMR) has complicated management strategies. Methodology: This study investigates the antimicrobial resistance (AMR) patterns of bacterial isolates from clinical specimens at Nova Diagnostics and Research in Mogadishu, Somalia, over a three-year period from June 2021 to July 2024. Result: A total of 650 patient specimens were analyzed, with bacterial growth identified in 647 samples. Among these, 98.2% were Gram-negative and predominantly aerobic, while 1.4% were Gram-positive, all aerobic. The most frequently isolated pathogens were Staphylococcus spp. (43.4%), followed by Escherichia coli (17.2%), Klebsiella (13.1%), and Pseudomonas (7.2%). Antimicrobial resistance was particularly concerning among Gram-negative bacteria. Staphylococcus exhibited high resistance to erythromycin (66.6%) and tetracycline (50.7%). Escherichia coli showed 84.8% resistance to ampicillin, while Klebsiella demonstrated 90.5% resistance to ampicillin. Gram-positive bacteria commonly exhibited resistance to Erythromycin, Trimethoprim/Sulfamethoxazole, Rifampicin, and Vancomycin. Conclusion: The high prevalence of resistant strains, particularly among Gram-negative bacteria like Staphylococcus spp. and Escherichia coli, presents significant challenges to effective treatment. The widespread resistance to multiple antibiotics underscores the urgent need for enhanced infection control, improved surveillance systems and researches, and comprehensive antimicrobial stewardship programs.

---

References

1.Moremi, N., Claus, H. and Mshana, S.E., 2016. Antimicrobial resistance pattern: a report of microbiological cultures at a tertiary hospital in Tanzania. BMC infectious diseases, 16, pp.1-7.

2.Aljamali, N.M., Al-zubaidy, Z.H. and Enad, A.H., 2021. Bacterial infection and common bacterial diseases: A Review. Pharm. Nanotechnol, 3, pp.13-23.

3.Sartorius, B., Gray, A.P., Weaver, N.D., Aguilar, G.R., Swetschinski, L.R., Ikuta, K.S., Mestrovic, T., Chung, E., Wool, E.E., Han, C. and Hayoon, A.G., 2024. The burden of bacterial antimicrobial resistance in the WHO African region in 2019: a cross-country systematic analysis. The Lancet Global Health, 12(2), pp.e201-e216.

4.Mulu, W., Abera, B., Yimer, M., Hailu, T., Ayele, H. and Abate, D., 2017. Bacterial agents and antibiotic resistance profiles of infections from different sites that occurred among patients at Debre Markos Referral Hospital, Ethiopia: a cross-sectional study. BMC research notes, 10, pp.1-9.

5.Kibret, M. and Abera, B., 2010. Antimicrobial resistance trend of bacteria from clinical isolates: An 8-year retrospective study at Dessie Regional Laboratory, Northeast Ethiopia. Ethiop Pharm J, 28, pp.39-46.

6.Dutta, S., Hassan, M.R., Rahman, F., Jilani, M.S.A. and Noor, R., 2013. Study of antimicrobial susceptibility of clinically significant microorganisms isolated from selected areas of Dhaka, Bangladesh. Bangladesh Journal of Medical Science, 12(1), p.34.

7.Woodford, N., Turton, J.F. and Livermore, D.M., 2011. Multiresistant Gram-negative bacteria: the role of high-risk clones in the dissemination of antibiotic resistance. FEMS microbiology reviews, 35(5), pp.736-755.

8.Gashaw, M., Berhane, M., Bekele, S., Kibru, G., Teshager, L., Yilma, Y., Ahmed, Y., Fentahun, N., Assefa, H., Wieser, A. and Gudina, E.K., 2018. Emergence of high drug resistant bacterial isolates from patients with health care associated infections at Jimma University medical center: a cross sectional study. Antimicrobial Resistance & Infection Control, 7, pp.1-8.

9.Obakiro, S.B., Kiyimba, K., Paasi, G., Napyo, A., Anthierens, S., Waako, P., Van Royen, P., Iramiot, J.S., Goossens, H. and Kostyanev, T., 2021. Prevalence of antibiotic-resistant bacteria among patients in two tertiary hospitals in Eastern Uganda. Journal of Global Antimicrobial Resistance, 25, pp.82-86.

10.Moussa, A.A., Abdulahi Abdi, A., Awale, M.A. and Garba, B., 2021. Occurrence and phenotypic characterization of multidrug-resistant bacterial pathogens isolated from patients in a public hospital in Mogadishu, Somalia. Infection and Drug Resistance, pp.825-832.

11.Kaye, K.S. and Pogue, J.M., 2015. Infections caused by resistant gram‐negative bacteria: epidemiology and management. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 35(10), pp.949-962.

12.Honda, H. and Warren, D.K., 2009. Central nervous system infections: meningitis and brain abscess. Infectious disease clinics of North America, 23(3), pp.609-623.

13.Arana, D.M., Rubio, M. and Alós, J.I., 2017. Evolution of antibiotic multiresistance in Escherichia coli and Klebsiella pneumoniae isolates from urinary tract infections: a 12-year analysis (2003–2014). Enfermedades infecciosas y microbiologia clinica, 35(5), pp.293-298.

14.El Mammery, A., Ramírez de Arellano, E., Cañada-García, J.E., Cercenado, E., Villar-Gómara, L., Casquero-García, V., García-Cobos, S., Lepe, J.A., Ruiz de Gopegui Bordes, E., Calvo-Montes, J. and Larrosa Escartín, N., 2023. An increase in erythromycin resistance in methicillin-susceptible Staphylococcus aureus from blood correlates with the use of macrolide/lincosamide/streptogramin antibiotics. EARS-Net Spain (2004–2020). Frontiers in microbiology, 14, p.1220286.

15.Gherardi, G., De Florio, L., Lorino, G., Fico, L. and Dicuonzo, G., 2009. Macrolide resistance genotypes and phenotypes among erythromycin-resistant clinical isolates of Staphylococcus aureus and coagulase-negative staphylococci, Italy. FEMS Immunology & Medical Microbiology, 55(1), pp.62-67.

16.Mohamed Ali, I., Duman, C., Bozdağ, İ., Artan Abdi, A., Nor Abdi, M., Emre Karakurt, S. and Yiğit, Ö., 2022. Microbiology and Drug Susceptibility Pattern of Bacterial Isolates from Patients with Chronic Suppurative Otitis Media at a Tertiary Care Hospital in Somalia. Infection and Drug Resistance, pp.7733-7739.