Mulu Andargachew, Moges Feleke, Tessema Belay, Kassu Afework
Department of Microbiology, Gondar College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
Ethiop Med J. 2006 Apr;44(2):125-31.
Antibiotics resistance among bacteria is a worldwide problem. The situation in developing countries like Ethiopia is particularly serious. Since the presence of drug resistant bacteria in the environment are threat for public health, up-to-date information on local pathogens and drug sensitivity pattern is very crucial to treat patients. The aim of this study is to assess the pattern of bacterial pathogens from wound infection and their susceptibility to common antibiotics.
This laboratory based retrospective study of 151 wound swabs and sensitivity tests was conducted in Bacteriology Laboratory of the University of Gondar Teaching Hospital. The samples were collected and processed following standard microbiological techniques as part of the routine clinical management of the patient. Antibiotic sensitivity testing was done on pure culture isolates employing disc-diffusion method for the commonly used antibiotics.
Bacterial pathogens were isolated from 79 patients showing an isolation rate of 52%. Staphylococcus aureus was the predominant species 65% (51/79) followed by Escherichia coli, 8/79 (10%), Klebsiella pneumoniae 9% (7/79), Proteus species 4% (3/79) and Streptococci species 4% (3/7). Among Gram-positive bacteria, S. aureus showed high level of drug resistance against penicillin 59% (30/51), tetracycline 57% (29/51), ampicillin 55% (28/51) and co-trimoxazole 35% (18/51). E. coli was found to be resistant to ampicillin in 87% (7/8), tetracycline also in 87% (7/8) and co-trimoxazole 63% (5/8). The over all multiple drug resistance patterns were found to be 78.5%.
The frequency of single as well as multiple drug resistance is alarmingly high. This might be a reflection of inappropriate use of antimicrobials, lack of diagnostic laboratory services or unavailability of guideline regarding the selection of drugs. Thus, rational use of drugs should be practiced.
细菌的抗生素耐药性是一个全球性问题。在埃塞俄比亚等发展中国家，情况尤为严重。由于环境中耐药细菌的存在对公众健康构成威胁，因此有关当地病原体和药敏模式的最新信息对于治疗患者至关重要。本研究的目的是评估伤口感染细菌病原体的模式及其对常用抗生素的敏感性。
本研究为基于实验室的回顾性研究，对151份伤口拭子及药敏试验进行分析，研究在贡德尔大学教学医院细菌学实验室开展。作为患者常规临床管理的一部分，按照标准微生物技术收集和处理样本。采用纸片扩散法对纯培养分离株进行常用抗生素的药敏试验。
从79例患者中分离出细菌病原体，分离率为52%。金黄色葡萄球菌是主要菌种，占65%（51/79），其次是大肠杆菌，占8/79（10%），肺炎克雷伯菌占9%（7/79），变形杆菌属占4%（3/79），链球菌属占4%（3/7）。在革兰氏阳性菌中，金黄色葡萄球菌对青霉素的耐药率较高，为59%（30/51），对四环素的耐药率为57%（29/51），对氨苄西林的耐药率为55%（28/51），对复方新诺明的耐药率为35%（18/51）。大肠杆菌对氨苄西林的耐药率为87%（7/8），对四环素的耐药率也为87%（7/8），对复方新诺明的耐药率为63%（5/8）。总体多重耐药模式为78.5%。
单一及多重耐药的频率高得惊人。这可能反映了抗菌药物使用不当、缺乏诊断实验室服务或缺乏药物选择指南。因此，应合理使用药物。
