Antimicrobial Resistance of Pseudomonas Aeruginosa Isolated From Patients With Wound Infection in Ethiopia. A Systematic Review Article 

Abstract Background: Infectious diseases have been major cause of morbidity and mortality all over the globe. The ability of bacterial pathogens to adapt and overcoming to treat by different antibiotics has been challenging in patient management. The antimicrobial resistance rates of Pseudomonas aeruginosa are known to fluctuate extensively in different settings. Active inspection of trends in antibiotic resistance of Pseudomonas aeruginosa is essential for the selection of suitable antimicrobial agent for empirical therapy. The objective of our systematic review was to determine the national antimicrobial resistance profile of Pseudomonas aeruginosa isolated from patients with wound infection in Ethiopia. Methods: We searched the Pub Med database in July and August 2018. We used the term ‘antimicrobial resistance, Pseudomonas aeruginosa, wound and Ethiopia’ to find articles published from 2011 to 2018 September. Only articles in English language were included. Full-text articles were incorporated if they reported the percentage of antibiotic resistance among clinical isolates of pathogenic bacteria collected from patients in any of the regions of Ethiopia. For overlapping studies reporting on the same clinical isolates, same study period and place, only the study with the largest sample size was included.Results: From the 173 Pseudomonas aeruginosa isolates 99.5%, 95% of the isolates were resistant to ampicilin and Amoxicillin Clavulanic Acid respectively. From the isolates 28.8%, 29.7% and 39.6% of them were resistant to Gentamicine, ciprofloxacin and Ceftazidime respectively. Most of the isolates have limited susceptibility to ampicillin, Amoxicillin Clavulanic Acid, tetracycline, cotromoxazole, chloramphenicol and ceftriaxone.Conclusion: Antimicrobial resistance is likely to become a challenge in Ethiopia and may be exacerbated by overuse of antibiotics, the lack of oversight of antibiotic prescription, and the lack of relevant local data on antimicrobial resistance. Therefore, existing antimicrobial stewardship programmes should be strengthened or, where they are not yet in place, they should be developed and implemented in all regional referral hospitals in response to these challenges and Health research institutes. Antimicrobial surveillance also needs to be strengthened.