Antimicrobial resistance of staphylococcus aureus; knowledge, attitude, and practices on antibiotic use among farmers in Isingiro and Kamuli districts – Uganda

Abstract

Bacterial resistance to antibiotics is fast becoming a big challenge as resistance to multiple drugs is rising rapidly. The emergence of resistant Staphylococcus aureus worldwide is life-threatening for both the human and animal sectors. The antimicrobial resistance (AMR) is accompanied by high morbidity and mortality. The study was designed to determine the prevalence of AMR in S. aureus among humans and animals, and the knowledge, attitude, and practice of farmers in relation to AMR of S. aureus. This was a cross-sectional study whereby households in Isingiro and Kamuli districts which have cattle were selected and nasal swab samples were collected from both animals and humans (farmers) and taken to the laboratory for processing and analysis using microbial techniques. Questionnaires were administered to the selected farmers to assess their knowledge, attitude, and practices. A total of 147 farmers were interviewed, 71 (48.3%) from Isingiro district and 76 (51.7%) from Kamuli district between July and September 2020. Data analysis was done using STATA version 15.0 with results reported as frequencies and percentages. The majority of the respondents were males in both Isingiro (77.5%) and Kamuli (71.4%). Cattle in Kamuli, S. aureus was isolated from 10/76 (13.2%, 95% CI 9.9-27.1) of animal swab samples. Cattle from Isingiro, S. aureus was isolated from 8/71 (11.3%, 95% CI 5.7-21.1) of animal swab samples. There was 100% susceptibility to Ciprofloxacin and Gentamycin among animals in both Kamuli and Isingiro. In Kamuli highest resistance was to penicillin G 100% and Metronidazole 100%. In Isingiro, highest resistance was to; Penicillin-G 75%, Ampicillin 87.5%, and Metronidazole 100%. Farmers in Kamuli, S. aureus was isolated from 29/76 (38.2%, 95% CI 24.7-66.2) of human swab samples. Farmers in Isingiro, S. aureus was isolated from 18/71 (25.4%, 95% CI 16.5-36.9) of human swab samples. In Isingiro there was 100% susceptibility to Ciprofloxacin and Gentamycin among humans. High resistance was to Penicillin G 94.7%, Ampicillin 94.7%, and Metronidazole (100%). In Kamuli high resistance was to Penicillin G 92.3%, Ampicillin 88.5%, and Metronidazole 100%. Farmers in Isingiro have better knowledge and attitude about AMR compared to those in Kamuli and the practices also significantly varied among farmers in the two districts (P-value < 0.05). 64.8% of the farmers in Isingiro said that the withholding period to wait until selling or consuming is 5 days, while the majority (34.67%) in Kamuli said there is no withholding period to wait until selling or consuming animal products. Staphylococcus aureus is still a burden among farmers in Isingiro and Kamuli districts and it was more prevalent in Kitayundwa and Mbaale sub-counts compared to Balawoli and Ndiizi sub-counts respectively. There is a need for a massive public awareness campaign to improve national awareness of AMR.