Botswana SHARE Network: Surveillance of Healthcare-associated infections & Antimicrobial Resistance

The World Health Organization has declared antimicrobial resistance (AMR) one of the top 10 global public health threats facing humanity. The incidence and mortality from healthcare-associated infections due to multidrug resistant organisms have dramatically increased in low- and middle-income countries during recent decades. Particularly in middle-income countries like Botswana, healthcare systems are rapidly expanding to provide a more diverse array of elective and essential care, which increasingly involve elective surgeries, routine deliveries, complex medical devices, and prolonged hospitalizations. Yet, infection prevention and control capacity, physical infrastructure of healthcare settings, and human resources to provide clinical care have not kept pace with the rapid growth in demand for and complexity of services.

The SHARE project is primarily a capacity-building assessment and quality improvement initiative to enhance Botswana’s ability to prevent, detect, and respond to infectious disease threats by strengthening hospital epidemiology programs and microbiology laboratory capacity. The aims of the SHARE project are to 1) enhance laboratory capacity to detect emerging AMR patterns; 2) strengthen hospital epidemiology programs to use data to prevent, detect, and contain emerging AMR threats; 3) deploy study teams to answer critical public health surveillance questions, and 4) to build a national network of infection prevention and control resources to prevent, detect, and contain emerging infectious disease threats. The project has supported building capacity through development of Standard Operating Procedures (SOPs), including the SOP for the Speciation and Antimicrobial Sensitivity Testing for Common Skin Flora Recovered from Clinical Blood Cultures.

Publications and presentations:

Strysko J, Thela T, Feder A, Thubuka J, Machiya T, Mkubwa J, Mochankana K, Tiroyakgosi C, Kgomanyane K, Ntereke TD, Zankere T. Carbapenem-resistant Acinetobacter baumannii at a hospital in Botswana: Detecting a protracted outbreak using whole genome sequencing. medRxiv 2023.07.10.23292487.

Strysko J, Thela T, Thubuka J, Machiya T, Mkubwa J, Tiroyakgosi C, Vurayai M, Kgomanyane K, Ntereke TD, Zankere T, Lechiile K. Hyperendemic carbapenem-resistant Acinetobacter baumannii at a hospital in Botswana: Insights from whole-genome sequencing. Antimicrobial Stewardship & Healthcare Epidemiology. 2023 Jun;3(S2):s115-6.

Vurayai M, Strysko J, Kgomanyane K, Bayani O, Mokomane M, Machiya T, Arscott-Mills T, Goldfarb DM, Steenhoff AP, McGann C, Nakstad B, Gezmu A, Richard-Greenblatt M, Coffin S. Characterizing the bioburden of ESBL-producing organisms in a neonatal unit using chromogenic culture media: a feasible and efficient environmental sampling method. Antimicrob Resist Infect Control. 2022 Jan 24;11(1):14.

Mochankana K, Nakstad B, Thubuka J, Machiya T, Goldfarb D, Richard-Greenblatt M, Zankere T, Strysko J. Culture confirmed neonatal bloodstream infections in Botswana 2019-2022: A cross-sectional study from a tertiary referral hospital implementing an automated blood culture system. 13th World Congress of The World Society for Pediatric Infectious Diseases; 2023 Nov 14-17; Durban, South Africa.


First Nations land acknowledegement

Action on Sepsis operates on the traditional, ancestral, and unceded territory of the Coast Salish peoples — xʷməθkʷəy̓əm (Musqueam), Sḵwx̱wú7mesh (Squamish), and Səl̓ílwətaʔ/Selilwitulh (Tsleil-Waututh) Nations. We invite everyone to reflect on the traditional territories and land that they currently work and live on.

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