Surveillance of Common Circulating Enteric Bacteria and Antimicrobial Susceptibility Patterns in Five Satellite Laboratories in Rwanda, 2014–2022

Abstract

Diarrhea diseases are a significant public health problem in Africa. In Rwanda, they are ranked third among the top causes of morbidity and mortality in children under five years of age. However, limited studies have been conducted to identify common circulating enteric pathogenic bacteria in Rwanda. In this study, we aimed to determine common circulating enteric pathogens and antimicrobial susceptibility patterns in Rwanda. The study was conducted by using a prospective cross-sectional design involving five satellite hospital laboratories. Two stool specimens from patients with diarrhea per site were collected between 2014 and 2022 and cultured using standard microbiology techniques. The isolated bacteria were tested for antimicrobial susceptibility patterns by using the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute guidelines. Of the 2,393 samples analyzed during the study, 217 (9%) exhibited bacterial growth. Isolated bacteria indicated the prevalence of Shigella spp. (4.4%), Vibrio cholerae (3.1%), Salmonella spp. (1.4%), and Escherichia coli (0.1%). A statistical analysis revealed that water source, hand washing, and boiled water were significantly associated with infection. Antimicrobial susceptibility testing revealed that Shigella spp. exhibited resistance to tetracycline (71%), ampicillin (68%), and chloramphenicol (42%). Vibrio cholerae exhibited resistance to ampicillin (51%), trimethoprim/sulfamethoxazole (49%), tetracycline (32%), gentamicin (32%), and chloramphenicol (26%). Antimicrobial sensitivity testing revealed that all isolated bacteria were sensitive to ciprofloxacin, whereas Vibrio cholerae and Salmonella spp. were most sensitive to tetracycline.