Mode
Text Size
Log in / Sign up

Temporal trends in ESKAPE pathogen distribution and AMR patterns observed in 3,778 isolates from RwandaAntibiotic resistance in Rwanda rose sharply from 55% to 83% in five years

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Note rising AMR to access antibiotics in Rwanda; strengthen stewardship and infection control.

This retrospective laboratory-based surveillance study examined temporal trends in the distribution and antimicrobial resistance (AMR) patterns of ESKAPE pathogens among 3,778 culture-positive clinical specimens processed at the University Teaching Hospital of Kigali (CHUK) in Rwanda. The observation period covered five years, from 2020 through 2024. The primary outcome assessed changes in pathogen prevalence and resistance rates over time, while secondary outcomes included phenotypic resistance patterns and trends by antibiotic category.

Klebsiella pneumoniae was the most prevalent pathogen, accounting for 43.8% of isolates, followed by Staphylococcus aureus at 26.4% and Acinetobacter baumannii at 15.1%. The overall AMR rate across all pathogens was 56.5%. Specific high-resistance organisms included Enterococcus spp. at 74.6%, A. baumannii at 69.9%, and Enterobacter spp. at 64.4%. Notably, Extended-spectrum β-lactamase-producing Enterobacterales were identified in 32.9% of cases, Methicillin-resistant Staphylococcus aureus in 31.1%, Carbapenem-resistant Enterobacterales in 15.6%, and Vancomycin-resistant Enterococci in 5%.

Resistance to access antibiotics increased from 54.7% in 2020 to 83.3% in 2024. Resistance to watch antibiotics rose from 42.5% in 2020 to 57.2% in 2024. Resistance to Reserve antibiotics remained comparatively lower. Adverse events, serious adverse events, discontinuations, and tolerability were not reported. Funding or conflicts of interest were not reported. The study did not report p-values or confidence intervals for these estimates.

Key limitations include the single-center design and lack of reported safety data. The study does not establish causality. These findings underscore an urgent need to strengthen antimicrobial stewardship, infection prevention, and control measures in this setting. Clinicians should interpret these trends as descriptive data from a specific hospital cohort rather than generalizable population-level statistics.

Researchers analyzed 3,778 bacterial samples collected at the University Teaching Hospital of Kigali in Rwanda between 2020 and 2024. They looked at how often specific germs appeared and how often they resisted standard treatments. The study found that overall antibiotic resistance rates increased significantly over this five-year period. Common germs like E. coli and Klebsiella became much harder to treat with the drugs doctors typically use first.

The data showed a worrying rise in resistance to 'access' antibiotics, which are usually the first line of defense. Resistance to these common drugs climbed from about 55% in 2020 to over 83% in 2024. While resistance to 'watch' and 'reserve' antibiotics remained comparatively lower, the trend for common drugs is urgent. Specific dangerous strains, such as methicillin-resistant Staphylococcus aureus and carbapenem-resistant bacteria, were also identified in the samples.

This study does not prove that a specific action caused this rise, but it clearly shows a growing threat to patient safety. The main takeaway is that hospitals in this region face a serious challenge in treating infections. Without stronger measures to prevent infections and manage antibiotic use, patients may find fewer effective options available to them. This situation calls for immediate attention to infection prevention and stewardship programs.

What this means for you:
Antibiotic resistance in Rwanda rose sharply from 55% to 83% in five years, urging stronger infection control.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
BackgroundAntimicrobial resistance (AMR) in Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp., known as ESKAPE pathogens, continue to pose a health threat globally. In Rwanda, data on long-term trends and resistance profiles among these pathogens remain limited. This study has assessed the temporal trends in the distribution and AMR patterns of ESKAPE pathogens at the University Teaching Hospital of Kigali (CHUK) from 2020 to 2024.MethodologyA retrospective laboratory-based surveillance study was conducted using microbiology laboratory data. All culture-positive clinical specimens processed over the five years were included. Descriptive analysis was performed to assess pathogens' distribution, resistance rates, phenotypic resistance patterns, and temporal trends according to antibiotic categories.ResultsA total of 3,778 culture-positive isolates were analyzed. Klebsiella pneumoniae was the most prevalent (43.8%), followed by Staphylococcus aureus (26.4%) and Acinetobacter baumannii (15.1%). The overall AMR rate was 56.5%, with the highest resistance observed in Enterococcus spp. (74.6%), Acinetobacter baumannii (69.9%), and Enterobacter spp. (64.4%). Resistance to access antibiotics increased from 54.7 % in 2020 to 83.3 % in 2024, while resistance to watch antibiotics rose from 42.5 % to 57.2%. ESKAPE Pathogens exhibited a comparatively lower resistance rate to the Reserve antibiotics, including polymyxin B and ceftazidime-avibactam. Phenotypic resistance analysis identified extended-spectrum β-lactamase-producing Enterobacterales (32.9 %), methicillin-resistant Staphylococcus aureus (31.1%), carbapenem-resistant Enterobacterales (15.6%), and vancomycin-resistant Enterococci (5%).ConclusionThis study demonstrates a high and increasing burden of multidrug-resistant ESKAPE pathogens, characterized by escalating resistance to first-line and second-line antibiotics and early indications of emerging resistance to last-resort antimicrobials. These findings highlight the urgent need to strengthen antimicrobial stewardship, infection prevention, and control measures.
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.