scholarly journals Antimicrobial stewardship among Nigerian children: A pilot study of the knowledge, attitude, and practices of prescribers at two tertiary healthcare facilities in Bayelsa State

2021 ◽  
Author(s):  
Ebiowei S.F Orubu ◽  
Faith O. Robert ◽  
Leonard Emuren ◽  
Boboye Ifie-Ombeh
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Rank Order ◽  
Data Availability ◽  
University Teaching ◽  
Easy Access ◽  
Antibiotic Prescribing ◽  
Healthcare Facilities ◽  
Tertiary Healthcare ◽  
Resistance Data

AbstractAntimicrobial stewardship (AMS), the evidence-based use of antimicrobials, is an effective strategy in controlling antimicrobial resistance (AMR) in humans by reducing the irrational use of antimicrobials. Stewardship in children is less studied. This study assessed the knowledge, attitude, and practice of physicians prescribing antibiotics to children in Bayelsa State, Nigeria to identify gaps in AMS and possible solutions. Following ethical approval, a semi-structured questionnaire was distributed among 40 paediatricians and gynaecologists at the two public tertiary healthcare facilities in Bayelsa State – the Niger Delta University Teaching Hospital and the Federal Medical Centre – for self-completion. Responses were expressed as percentages and analyzed using Bloom’s cutoffs. The Capability, Opportunity, Motivation, and Behaviour (COM-B) model was employed to identify gaps for intervention in prescribing behavior with gaps in each component identified by aggregate scores <80%. Perceived approaches to improve prescribing among 14 selected options were assessed using 5-point Likert scales and options with scores >90% rated the most acceptable. Questionnaires were administered from August to September 2021. The response rate was 68% (27/40). Participants were paediatricians (81%, 22/27) and gynaecologists (19%, 5/27). Antimicrobial Susceptibility Testing (AST) was not performed before antibiotic selection nine times out of 10 (89%, 24/27). In a third (37%, 10/27) of cases, 2-3 antibiotics were prescribed. The top three antibiotics, in rank order, were: cefuroxime or amoxicillin 41% (11/27); ciprofloxacin or amoxicillin 30% (8/27), and azithromycin (33%, 9/27). Aggregate COM-B scores were: capability, 74%; opportunity, 78%; and motivation, 87%. The most acceptable (100%, 27/27) options to improving antibiotic prescribing were: availability of resistance data, availability of guidelines, readily accessible microbiological data, and easy access to infectious disease physicians. There are gaps in knowledge of AMR and opportunity for rational prescribing. There is need for antimicrobial resistance data to promote pediatric AMS at the surveyed healthcare facilities.

scholarly journals 2027. What Are the Views Among Pakistani Physicians Toward Antimicrobial Resistance and Hospital Antimicrobial Stewardship Programs? A Multi-Site Qualitative Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S681-S681
Author(s):  
Khezar Hayat ◽  
Meagen Rosenthal ◽  
Ali Hassan Gillani ◽  
Panpan Zhai ◽  
Wenjing Ji ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Tertiary Care ◽  
Public Hospitals ◽  
Teaching Hospitals ◽  
Public Health Issue ◽  
Antibiotic Prescribing ◽  
Healthcare Facilities ◽  
Face To Face ◽  
Stewardship Program

Abstract Background Antimicrobial resistance (AMR) is a major public health issue that the world is facing in the 21st century and implementation of antimicrobial stewardship program (ASP) is one of the recognized approaches to combat AMR. Little is known on the views among Pakistani physicians regarding AMR and the benefits of hospital ASP implementation. This study was aimed to investigate the perception and attitude of physicians about AMR and ASP. Methods Qualitative face-to-face and telephonic interviews were conducted by using purposive sampling method with 22 physicians working in seven tertiary care public hospitals of Punjab, Pakistan. All interviews were audio-recorded and transcribed verbatim. Qualitative software was used, and a thematic analysis conducted. Results Three major themes were identified: (1) the growing concern of AMR in Pakistan, (2) the role(s) of healthcare professionals in antibiotic prescribing and infection control, and (3) managing antibiotic resistance in hospitals. Poor healthcare facilities, insufficient trained medical staff, and inadequate resources were the key barriers in the implementation of ASP in Pakistan. Conclusion Physicians of public sector tertiary care teaching hospitals have shown poor familiarity toward hospital ASPs but the concept of hospital ASPs in Pakistan can be established by using the distinct themes that originated during this study. Overall, the attitude of physicians was positive toward its enforcement in all types of hospital settings including teaching hospitals. Disclosures All authors: No reported disclosures.

scholarly journals Perspective of Pakistani Physicians towards Hospital Antimicrobial Stewardship Programs: A Multisite Exploratory Qualitative Study

2019 ◽  
Vol 16 (9) ◽  
pp. 1565 ◽  
Author(s):  
Khezar Hayat ◽  
Meagen Rosenthal ◽  
Ali Hassan Gillani ◽  
Panpan Zhai ◽  
Muhammad Majid Aziz ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Tertiary Care ◽  
Public Hospitals ◽  
Teaching Hospitals ◽  
Antibiotic Prescribing ◽  
Healthcare Facilities ◽  
Healthcare Settings ◽  
Stewardship Program ◽  
Global Threat

Background: Antimicrobial resistance (AMR) is a global threat and the antimicrobial stewardship program (ASP) is a globally used tool to combat AMR. There is little information on the views among Pakistani physicians regarding AMR and the benefits of hospital antimicrobial stewardship implementation. This study was designed to explore the physicians’ views about ASP. Methods: Qualitative face-to-face and telephonic interviews were conducted by using purposive sampling method with 22 physicians working in seven tertiary care public hospitals of Punjab, Pakistan. All interviews were audio recorded and transcribed verbatim. Qualitative software was used, and a thematic analysis was conducted. Results: Three broad themes were identified: (1) the growing concern of antimicrobial resistance in Pakistan, (2) the role(s) of healthcare professionals in antibiotic prescribing, and (3) managing antibiotic resistance in hospitals. Inadequate resources, poor healthcare facilities, and insufficiently trained medical staff were the major hurdles in ASP implementation in Pakistan. Conclusions: Our study found a poor familiarity of hospital ASP among physicians working in public sector tertiary care teaching hospitals, and a number of distinct themes emerged during this study that could be helpful in establishing the concept of hospital ASP in Pakistan. Overall, physicians showed a positive attitude towards the enforcement of ASP in all healthcare settings, including teaching hospitals.

scholarly journals 229. Hospitalists Antimicrobial Scorecard Improves Antibiotic Prescribing at a Community Teaching Hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S116-S116
Author(s):  
Julia Sessa ◽  
Helen Jacoby ◽  
Bruce Blain ◽  
Lisa Avery
Keyword(s):  
Patient Care ◽  
Teaching Hospital ◽  
Antimicrobial Stewardship ◽  
Rank Order ◽  
Antibiotic Use ◽  
Outpatient Setting ◽  
Antibiotic Prescribing ◽  
Full Time ◽  
Days Of Therapy ◽  
The Impact

Abstract Background Measuring antimicrobial consumption data is a foundation of antimicrobial stewardship programs. There is data to support antimicrobial scorecard utilization to improve antibiotic use in the outpatient setting. There is a lack of data on the impact of an antimicrobial scorecard for hospitalists. Our objective was to improve antibiotic prescribing amongst the hospitalist service through the development of an antimicrobial scorecard. Methods Conducted in a 451-bed teaching hospital amongst 22 full time hospitalists. The antimicrobial scorecard for 2019 was distributed in two phases. In October 2019, baseline antibiotic prescribing data (January – September 2019) was distributed. In January 2020, a second scorecard was distributed (October – December 2019) to assess the impact of the scorecard. The scorecard distributed via e-mail to physicians included: Antibiotic days of therapy/1,000 patient care days (corrected for attending census), route of antibiotic prescribing (% intravenous (IV) vs % oral (PO)) and percentage of patients prescribed piperacillin-tazobactam (PT) for greater than 3 days. Hospitalists received their data in rank order amongst their peers. Along with the antimicrobial scorecard, recommendations from the antimicrobial stewardship team were included for hospitalists to improve their antibiotic prescribing for these initiatives. Hospitalists demographics (years of practice and gender) were collected. Descriptive statistics were utilized to analyze pre and post data. Results Sixteen (16) out of 22 (73%) hospitalists improved their antibiotic prescribing from pre- to post-scorecard (χ 2(1)=3.68, p = 0.055). The median antibiotic days of therapy/1,000 patient care days decreased from 661 pre-scorecard to 618 post-scorecard (p = 0.043). The median PT use greater than 3 days also decreased significantly, from 18% pre-scorecard to 11% post-scorecard (p = 0.0025). There was no change in % of IV antibiotic prescribing and no correlation between years of experience or gender to antibiotic prescribing. Conclusion Providing antimicrobial scorecards to our hospitalist service resulted in a significant decrease in antibiotic days of therapy/1,000 patient care days and PT prescribing beyond 3 days. Disclosures All Authors: No reported disclosures

scholarly journals Perceptions, Current Practices and Interventions of Community Pharmacists Regarding Antimicrobial Stewardship: A Qualitative Study in France

2021 ◽  
Author(s):  
Claire Durand ◽  
Aude Chappuis ◽  
Eric Douriez ◽  
Frédérique Poulain ◽  
Raheelah Ahmad ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Antimicrobial Resistance ◽  
Community Health ◽  
Antimicrobial Stewardship ◽  
Thematic Analysis ◽  
Community Pharmacists ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Community Health Care

Abstract Background: Community health care accounts for the vast majority of antibiotic use in Europe. Given the threat of antimicrobial resistance (AMR), there is an urgent need to develop new antimicrobial stewardship (AMS) interventions in primary care that could involve different health care providers including community pharmacists. This study aimed to explore the perceptions, currents practices and interventions of community pharmacists regarding antimicrobial stewardship.Methods: Semi-structured qualitative interviews were conducted with community pharmacists in France. Participants were recruited through a professional organization of community pharmacists combined with a snowballing technique. Interviews were audio recorded, transcribed and analyzed using thematic analysis. The Consolidated Framework for Implementation Research was used while developing the interview guide and carrying out thematic analysis.Results: Sixteen community pharmacists participated. All the respondents had good awareness about antimicrobial resistance and believed community pharmacists had an important role in tackling AMR. Some barriers to community pharmacists’ participation in AMS were identified such as difficult interactions with prescribers, lack of time and lack of access to patient medical records and diagnosis. Increased patient education, audits and feedback of antibiotic prescribing, increased point-of-care testing and delayed prescribing were interventions suggested by the pharmacists to improve antibiotic use in primary care. Strategies cited by participants to facilitate the implementation of such interventions are increased pharmacist-general practitioner collaboration, specialized training, clinical decision support tools as well as financial incentives. Conclusions: This study suggests that community pharmacists could play a greater role in infection management and AMS interventions. Further interprofessional collaboration is needed to optimize antibiotic prescribing and utilization in community health care.

scholarly journals Status of antimicrobial stewardship programmes in Nigerian tertiary healthcare facilities: Findings and implications

2019 ◽  
Vol 17 ◽  
pp. 132-136 ◽  
Author(s):  
Joseph O. Fadare ◽  
Olayinka Ogunleye ◽  
Garba Iliyasu ◽  
Adekunle Adeoti ◽  
Natalie Schellack ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Healthcare Facilities ◽  
Tertiary Healthcare

scholarly journals Antimicrobial Stewardship Programmes in Saudi Hospitals: Evidence from a National Survey

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 193 ◽  
Author(s):  
Saleh Alghamdi ◽  
Ilhem Berrou ◽  
Zoe Aslanpour ◽  
Alaa Mutlaq ◽  
Abdul Haseeb ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Treatment Success ◽  
National Level ◽  
Success Rates ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Healthcare Facilities

Saudi hospitals and healthcare facilities are facing increasing rates of antimicrobial resistance and the emergence of new multi-drug resistant strains. This is placing an unprecedented threat to successful treatments and outcomes of patients accessing those facilities. The inappropriate use of antimicrobials is fueling this crisis, warranting urgent implementation of interventions to preserve antimicrobials and reduce resistance rates. Antimicrobial stewardship programmes (ASPs) can improve antimicrobial use, treatment success rates and reduce the levels of antimicrobial resistance. The Saudi Ministry of Health (MOH) devised a national antimicrobial stewardship plan to implement ASPs in hospitals, but little is known about the progress of implementation and the factors affecting it. This study aims to assess the level and the factors affecting the adoption and implementation of ASPs in Saudi hospitals at a national level. A nationwide cross-sectional survey was conducted in 2017 using an online questionnaire sent to all MOH hospitals. Overall, 147 out 247 MOH hospitals responded to the survey (54%). Only 26% of the hospitals reported the implementation of ASPs. Hospitals lack the knowledge, technological and staff resources to adopt and implement ASPs. Alternative models of ASP adoption could be explored to improve the rates of implementation of ASPs.

Antimicrobial stewardship: Australia

2016 ◽  
Vol 21 (3) ◽  
pp. 139-149 ◽  
Author(s):  
Allan D. Spigelman ◽  
Shane Rendalls ◽  
Mary-Louise McLaws ◽  
Ashleigh Gray
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
World Health ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Content Type ◽  
Research Education ◽  
Australian Health ◽  
Organization Policy ◽  
Health Organization

Purpose – The purpose of this paper is to provide an overview of the context for strategies to overcome antimicrobial resistance in Australia, which may provide valuable learnings for other jurisdictions. Design/methodology/approach – Non-systematic review of literature from websites of national, state and territory health departments and interviews with key stakeholders for Australian strategies to reduce antimicrobial resistance. Findings – In July 2015 all states and territories in Australia adopted the National Antimicrobial Resistance Strategy 2015-2019, which is built on the World Health Organization policy package to combat antimicrobial resistance. This strategy represents “the collective, expert views of stakeholders on how best to combat antimicrobial resistance in Australia. It will also support global and regional efforts, recognising that no single country can manage the threat of antimicrobial resistance alone”. It combines quantitative and qualitative monitoring strategies with frameworks and guidelines to improve management of the use of antimicrobial resistant drugs. Prior to this, health services and states developed and implemented initiatives aimed at monitoring and improving prescribing practices. Development of the national strategy has encouraged and fostered debate within the Australian health system and a raft of new policy initiatives. Research limitations/implications – Surveillance strategies are in place to monitor impact and trends at jurisdictional and sector levels. However, actual impact on antimicrobial resistance and prescribing practices remains to be seen as existing initiatives are expanded and new initiatives implemented. Practical implications – This overview of key Australian initiatives balancing quantitative and qualitative surveillance, accreditation, research, education, community awareness and price signals on antibiotic prescribing practices may be valuable to health systems in developing local strategies. Originality/value – The authors provide an up to date overview of the context, strategies and aims of antimicrobial stewardship in Australia.

scholarly journals Roll out of a successful antimicrobial stewardship programme in Lagos University Teaching Hospital Nigeria using the Global-Point Prevalence Survey

2021 ◽  
Vol 22 (2) ◽  
pp. 260-272
Author(s):  
P.O. Oshun ◽  
A.A. Roberts ◽  
C.S. Osuagwu ◽  
P.E. Akintan ◽  
I.B. Fajolu ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Antimicrobial Resistance ◽  
Teaching Hospital ◽  
Antimicrobial Stewardship ◽  
Education And Training ◽  
University Teaching ◽  
Surgical Prophylaxis ◽  
Antimicrobial Prescribing ◽  
And Training ◽  
Roll Out

Background: Antimicrobial resistance (AMR) has become a public health emergency with increasing rates and spread globally. Antimicrobial stewardship (AMS) has been advocated to reduce the burden of antimicrobial resistance, promote rational and appropriate use of antibiotics and improve clinical outcomes. Education and training are one of the AMS interventions to improve antimicrobial use. We present the roll out of a successful AMS programme with education and training using the Global-PPS as data collection tool to measure AMS interventions and impact.Methodology: This was a cross sectional study on the implementation of an AMS programme at the Lagos University Teaching Hospital. Global PPS was conducted in 2015 to collect baseline data which was used to identify targets for quality improvement in AMS and was repeated in 2017 and 2018 to measure impact of AMS interventions. AMS interventions included education, feedback of Global-PPS result and writing of the hospitalwide antibiotic policy based on the baseline data.Results: Out of the 746 inpatients surveyed, 476 (68.3%) had received at least one antimicrobial on the days of Global-PPS. The antimicrobial prescribing rates reduced significantly over the three time periods. In 2015, 82.5% were placed on antimicrobials, 65.5% in 2017 and 51.1% in 2018 (p<0.00001). The documentation of indication for treatment significantly improved from 53.4% in 2015 to 97.2% in 2018 (p<0.0001). Stop review date also significantly improved from 28.7% to 70.2% in 2018 (p<0.00001). Surgical prophylaxis for more than 24 hours reduced significantly from 93.3% in 2015 to 65.7% in 2018 (p=0.002) even though the prevalence was still high. The three most commonly administered antimicrobial groups were third generation cephalosporins, imidazole derivatives and quinolones. The most commonly prescribed antibiotics for surgical prophylaxis were ceftriaxone and metronidazole in 2015 and ceftriaxone in 2017.Conclusion: The use of education and training as AMS intervention in a limited resource setting clearly made impact on antimicrobial prescribing patterns in the hospital. Global-PPS is useful to set quality improvement targets and for monitoring, evaluation and surveillance of an AMS programme. Keywords: Antibiotic, Stewardship, Resistance, Education, Global-PPS

scholarly journals Antimicrobial Stewardship Approach: Strategy to Enhance Antimicrobial Stewardship Programs in Arizona Long-Term Care

2020 ◽  
Vol 41 (S1) ◽  
pp. s122-s123
Author(s):  
Juan Villanueva ◽  
David Nix ◽  
Rachana Bhattarai ◽  
Kenneth Komatsu ◽  
Elizabeth Kim
Keyword(s):  
Antimicrobial Stewardship ◽  
Long Term Care ◽  
Antibiotic Prescribing ◽  
Duration Of Treatment ◽  
Term Care ◽  
Healthcare Facilities ◽  
Start Date ◽  
Days Of Therapy ◽  
Prescription Rates

Background: Implementing robust antimicrobial stewardship programs within long-term care facilities (LTCFs) presents unique challenges not typically seen in other healthcare settings. These facilities tend to care for older adults, rely on limited on-site clinician availability and experience higher-than-normal staff turnover. Many LTCFs lack the resources and expertise to track and analyze antibiotics usage. Through a collaborative effort between the Arizona Department of Health Services and the University of Arizona College of Pharmacy, support for carrying out stewardship activities was provided to these healthcare facilities. Our objective was to assess the viability of using pharmacy prescribing data to evaluate antibiotics usage among LTCFs throughout Arizona to assist in development of antimicrobial stewardship interventions. Methods: We invited interested LTCFs to participate in the development and enhancement of antimicrobial stewardship programs. We analyzed antibiotic prescribing data from November 2017 through November 2018 to assess the types and quantities of antibiotics prescribed. We worked with pharmacies to obtain a deidentified dataset that included unique patient identifiers, transaction (start) date, agent name, directions for use, route of administration, quantity dispensed, and stop dates. We estimated duration of treatment by assessing antibiotic starts using the number of transaction dates and unique patient identifiers for repeat prescriptions. Each agent was evaluated individually and assigned to an antibiotic category to better assess cumulative prescribing. Results: Through assistance from our community partners, we recruited 11 facilities to participate and worked with 5 servicing pharmacies to obtain a complete dataset for 6 LTCFs. For the facilities evaluated, there were a total of 4,654 antibiotic prescriptions. The most commonly prescribed antibiotic categories were fluroquinolones (24.3% of prescriptions) and oral β-lactams (17.8% of prescriptions). The third most commonly prescribed antibiotics were agents utilized against methicillin-resistant Staphylococcus aureus (MRSA) (13.7% of prescriptions). Antibiotic duration ranged from 1 to 304 days of therapy. Conclusions: Working directly with servicing pharmacies is an efficient way to obtain antibiotic prescribing data for LTCFs. During the 1-year period evaluated, antibiotic prescription rates varied between LTCFs. Despite numerous warnings, the fluroquinolone class continue to be among the most commonly prescribed antibiotics. Visualizing trends in LTCFs antibiotic data is an optimal way to develop and enhance antimicrobial stewardship programs in LTCFs. This fundamental information can help identify areas in which a facility can focus their stewardship efforts and provide a baseline for monitoring progress over time.Funding: NoneDisclosures: None

scholarly journals ESβL, AmpC and carbapenemase co-production in multi-drug resistant Gram-negative bacteria from HIV-infected patients in southwestern Nigeria

2021 ◽  
Vol 22 (1) ◽  
pp. 38-51
Author(s):  
F.M. Adeyemi ◽  
S.B. Akinde
Keyword(s):  
Control Measures ◽  
University Teaching ◽  
Teaching Hospitals ◽  
Multi Drug Resistance ◽  
Gram Negative Bacteria ◽  
Southwestern Nigeria ◽  
Gram Negative ◽  
Healthcare Facilities ◽  
Infection Control Measures ◽  
Tertiary Healthcare

Background: The rising global emergence of Gram-negative bacteria (GNB) producing β-lactam hydrolysing enzymes in clinical infections constitutes a growing public health threat. This study investigated the occurrence of co-production of extended spectrum β-lactamase (ESβL), AmpC β-lactamases, and carbapenemases among GNB isolated from HIVinfected patients in two tertiary healthcare facilities in southwest Nigeria.Methodology: A total of 115 GNB isolates previously recovered from HIV-infected patients at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, and the State Specialist Hospital, Akure, were investigated. The isolates were characterized to species level with the Microbact 24E kit and screened for ESβL production using the double-disc test (DDT) and combination disc methods, AmpC using modified Hodge test (MHT) and AmpC EDTA disc, and carbapenemase production using the MHT and EDTA disc test. Antibiotic susceptibility testing (AST) was performed by the Kirby-Bauer disc diffusion method.Results: A total of 15 species of GNB were characterized. The AST profile of the isolates revealed high resistance rates to ampicillin (94.5%), tetracycline (74.5%), sulphamethoxazole-trimethoprim (66.3%), and lowest resistance to imipenem (10.9%). Multi-drug resistance (MDR) was observed in 93.6% while 98.8% of ESβL, AmpC, and carbapenemase-producing isolates had multiple antibiotic resistance (MAR) indices ≥ 0.2. ESβL production was detected in 53.9%, AmpC in 20.9% and carbapenemase in 25.2% of the isolates. ESβL, AmpC or carbapenemase or co-production of two or all three enzymes was detected in 80 (69.6%) isolates, while only 10.0% produced all three enzymes.Conclusion: The isolation of MDR bacteria and isolates co-producing β-lactam hydrolysing enzymes in immunocompromised individuals portend grave consequences. Routine screening for these enzymes in MDR bacteria will be highly essential to guide the institution of appropriate antibiotic therapy and infection control measures. Keywords: ESβL, AmpC, carbapenemase, HIV, MDR, clinical isolates, MHT, DDST   French Title: Coproduction d'ESβL, AmpC et carbapénémase dans des bactéries Gram-négatives multirésistantes de patients infectés par le VIH dans le sud-ouest du Nigéria Contexte: L'émergence mondiale croissante de bactéries à Gram négatif (GNB) produisant des enzymes d'hydrolyse de β-lactame dans les infections cliniques constitue une menace croissante pour la santé publique. Cette étude a examiné l'occurrence de la coproduction de β-lactamases à spectre étendu (ESβL), de  β-lactamases AmpC et de carbapénémases parmi les GNB isolés de patients infectés par le VIH dans deux établissements de santé tertiaires du sud-ouest du Nigéria. Méthodologie: Un total de 115 isolats de GNB précédemment récupérés de patients infectés par le VIH au complexe hospitalier universitaire Obafemi Awolowo, Ile-Ife, et au State Specialist Hospital, Akure, ont été  étudiés. Les isolats ont été caractérisés au niveau des espèces avec le kit Microbact 24E et criblés pour la  production d'ESβL en utilisant le test à double disque (DDT) et les méthodes de disques combinés, AmpC en utilisant le test Hodge modifié (MHT) et le disque AmpC EDTA, et la production de carbapénémase en utilisant le MHT et test de disque EDTA. Le test de sensibilité aux antibiotiques (AST) a été effectué par la méthode de diffusion de disque de Kirby-Bauer Résultats: Un total de 15 espèces de GNB ont été caractérisées. Le profil AST des isolats a révélé des taux derésistance élevés à l'ampicilline (94,5%), à la tétracycline (74,5%), au sulfaméthoxazole-triméthoprime (66,3%) età la plus faible résistance à l'imipénème (10,9%). Une résistance à plusieurs médicaments (MDR) a été observéedans 93,6% tandis que 98,8% des isolats producteurs d'ESβL, AmpC et carbapénémase avaient de multiples indices de résistance aux antibiotiques (MAR) ≥ 0,2. La production d'ESβL a été détectée dans 53,9%, AmpC dans 20,9% et carbapénémase dans 25,2% des isolats. ESβL, AmpC ou carbapénémase ou la coproduction de deux ou des trois enzymes a été détectée dans 80 isolats (69,6%), tandis que seulement 10,0% ont produit les trois enzymes. Conclusion: L'isolement des bactéries MDR et des isolats co-producteurs d'enzymes d'hydrolyse des β-lactamines chez les individus immunodéprimés laisse présager de graves conséquences. Le dépistage systématique de ces enzymes dans les bactéries MDR sera très essentiel pour guider la mise en place d'une antibiothérapie appropriée et de mesures de contrôle des infections. Mots-clés: ESβL, AmpC, carbapénémase, VIH, MDR, isolats cliniques, MHT, DDST

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