Asrat D, Amanuel Y W
Department of Medical Microbiology and Parasitology, Faculty of Medicine, Addis Ababa University, P.O. Box 9086, Addis Ababa.
Ethiop Med J. 2001 Apr;39(2):97-104.
Between Mid-1996 and Mid-1998, 238 bacteria strains isolated from blood culture of adult patients of Tikur Anbassa Hospital, Addis Ababa, Ethiopia, were retrospectively analyzed for their frequency of isolation and antibiotic susceptibility pattern. Coagulase negative Staphylococcus aureus (CNS) were isolated with the highest frequency 103 (43.3%), followed by Staphylococcus aureus 34(14.3%), Klebsiella spp. 23(9.7%), E. Coli 19(8.1%), Pseudomonas spp. 16(6.7%), Acinetobacter spp. 12(5%), Salmonella spp. 9(3.8%) and miscellaneous group 22(9.2%). The gram positive bacteria constituted 149(62.6%) of the total blood isolates. It is suggested that a proportion of both the gram positive and gram negative isolated represent contaminants at blood sampling. Rates of susceptibility for gram positive range from 12% to 76%, and for gram negatives range from 8% to 46%. In general, rates of susceptibilities to all antibiotics tested for gram negatives were very low as compared to gram positives. Among the gram positives, more than half of the isolates were sensitive to amoxicillin + clavulanic acid, ampicillin, carbenicillin, cephalothin, chloramphenicol, erythromycin and methicillin. Gram negative bacteria showed a high rate of resistance to many of the commonly prescribed antimicrobial drugs: amoxicillin + clavulanic acid (65%), ampicillin (87.5%), amoxicillin (91.7%), carbenicillin (75%), cephalothin (73.6%), chloramphenicol (65%), gentamicin (55.6%), kanamycin (54%), trimethoprim-sulphamethoxazole (64%) and tetracycline (61%). If generally considered, only gentamicin and kanamycin were relatively effective against gram negatives. Over 85% Salmonella spp were sensitive to chloramphenicol and trimethoprim-sulphamethoxazole. Compared to previous studies done in the same hospital, there is a higher rate of antibiotic resistance for most types of blood culture isolates particularly for gram negatives. The rational use of drugs should be practiced in order to minimize the spread of drug resistant bacteria.
1996年年中至1998年年中，对从埃塞俄比亚亚的斯亚贝巴提库尔安巴萨医院成年患者血培养中分离出的238株细菌菌株进行回顾性分析，以了解其分离频率和抗生素敏感性模式。凝固酶阴性金黄色葡萄球菌（CNS）的分离频率最高，为103株（43.3%），其次是金黄色葡萄球菌34株（14.3%）、克雷伯菌属23株（9.7%）、大肠杆菌19株（8.1%）、假单胞菌属16株（6.7%）、不动杆菌属12株（5%）、沙门菌属9株（3.8%）以及其他菌群22株（9.2%）。革兰氏阳性菌占血液分离菌总数的149株（62.6%）。提示革兰氏阳性和革兰氏阴性分离菌中均有一部分在采血时可能为污染菌。革兰氏阳性菌的药敏率在12%至76%之间，革兰氏阴性菌的药敏率在8%至46%之间。总体而言，与革兰氏阳性菌相比，革兰氏阴性菌对所有测试抗生素的药敏率都非常低。在革兰氏阳性菌中，超过一半的分离株对阿莫西林+克拉维酸、氨苄西林、羧苄西林、头孢噻吩、氯霉素、红霉素和甲氧西林敏感。革兰氏阴性菌对许多常用抗菌药物显示出较高的耐药率：阿莫西林+克拉维酸（65%）、氨苄西林（87.5%）、阿莫西林（91.7%）、羧苄西林（75%）、头孢噻吩（73.6%）、氯霉素（65%）、庆大霉素（55.6%）、卡那霉素（54%）、甲氧苄啶-磺胺甲恶唑（64%）和四环素（61%）。一般而言，只有庆大霉素和卡那霉素对革兰氏阴性菌相对有效。超过85%的沙门菌属对氯霉素和甲氧苄啶-磺胺甲恶唑敏感。与该医院之前的研究相比，大多数类型的血培养分离株，尤其是革兰氏阴性菌，抗生素耐药率更高。应合理使用药物，以尽量减少耐药菌的传播。
