This comprehensive study focuses on skin and soft tissue infections (SSTIs), a common issue often overlooked in the National Action Plan on antimicrobial resistance (NAP-AMR) in Tanzania. The research is centered on assessing the magnitude of laboratory-confirmed SSTIs, identifying the bacterial species involved, observing the Antimicrobial Resistance (AMR) phenotypes, and investigating the risk factors associated with multidrug-resistant (MDR) SSTIs.
This analytical cross-sectional study, conducted from January to June 2023, involved 614 patients with SSTIs. Patient information was collected using standard AMR surveillance tools, and specimens were collected and analyzed using standard microbiological procedures, WHONET, and STATA software programs.
Findings revealed that about 72.5% (445/614) of patients had laboratory-confirmed SSTIs. The most frequent SSTIs types were surgical site infections, chronic wounds, and traumatic wounds. The commonest pathogens were Staphylococcus aureus and Escherichia coli. AMR phenotypes identified included methicillin-resistant Staphylococcus aureus, 29.0%; Extended-spectrum beta-lactamase producing Gram-negative bacteria, 47.3%; and carbapenem-resistant Gram-negative bacteria, 12.9%.
Significantly, the MDR SSTIs rate was higher among inpatients compared to outpatients. These findings highlight the urgent need to revisit SSTIs treatment guidelines at the Bugando Medical Centre (BMC) and the inclusion of SSTIs in the on-going AMR surveillance in Tanzania.
The study provides indispensable local research-evidence aimed at developing treatment guidelines to foster improved patient outcomes in Tanzania. Furthermore, learning gathered from the research underscores the need for strengthening country- and regional-specific surveillance programs. SSTIs are proposed to be included in the Tanzania NAP-AMR surveillance to ensure holistic patient management.