Ozumba Uchenna Chinedu
Department of Medical Microbiology, University of Nigeria Teaching Hospital, Enugu, Nigeria.
J Natl Med Assoc. 2005 Dec;97(12):1714-8.
The resistance of bacteria to antibiotics, particularly those used for first-line therapy, is an increasing cause for concern. Unfortunately, in Nigeria, much of the antibiotic therapy is not laboratory individualized or even laboratory extrapolated, leading to empirical prescription.
To determine the prevalence of antibiotic resistance among common pathogens in the University of Nigeria Teaching Hospital (Enugu, Nigeria) and to proffer solutions that will help decrease the prevalence.
All clinical isolates, which were isolated by routine methods from routine specimens, sent to the microbiology department had their antibiotic sensitivity performed on sensitivity test agar (Biotec, United Kingdom) using the disc diffusion method in accordance with the National Committee for Clinical Laboratory Standards.
Most of the Staphylococcus aureus and coagulase-negative staphylococci were resistant to common anti-staphylococcal drugs. Sixty-four percent of the coliforms were multidrug resistant. A similar pattern was observed for Pseudomonas aeruginosa. With regards to nonurinary isolates of coliforms, higher rates of resistance were noticed to ampicillin, gentamycin, colistin and ciprofloxacin when compared to urinary isolates.
There is a need for a continuous surveillance program of resistant bacteria to provide the basis for empirical therapy. At the same time, continued adherence to antibiotic policy and procedures in preventing cross-infection is important in the control of antimicrobial resistant bacteria.
细菌对抗生素,尤其是一线治疗中使用的抗生素产生耐药性,这一问题日益令人担忧。不幸的是,在尼日利亚,大部分抗生素治疗并非根据实验室个体化方案进行,甚至不是基于实验室推断,而是经验性处方。
确定尼日利亚大学教学医院(埃努古)常见病原体中的抗生素耐药率,并提出有助于降低该耐药率的解决方案。
所有通过常规方法从常规标本中分离出来并送至微生物科的临床分离株,按照美国国家临床实验室标准委员会的规定,采用纸片扩散法在药敏试验琼脂(英国百泰克)上进行抗生素敏感性检测。
大多数金黄色葡萄球菌和凝固酶阴性葡萄球菌对常见的抗葡萄球菌药物耐药。64%的大肠埃希菌属多重耐药。铜绿假单胞菌也呈现出类似模式。就大肠埃希菌属的非尿液分离株而言,与尿液分离株相比,其对氨苄西林、庆大霉素、黏菌素和环丙沙星的耐药率更高。
需要对抗耐药菌进行持续监测,为经验性治疗提供依据。同时,在预防交叉感染方面持续遵守抗生素政策和程序,对于控制抗菌药物耐药菌至关重要。