Mulu Wondemagegn, Kibru Gebre, Beyene Getenet, Damtie Meku
Department of Medical Microbiology, Bahirdar University.
Ethiop J Health Sci. 2012 Mar;22(1):7-18.
Nosocomial infection constitutes a major public health problem worldwide. Increasing antibiotic resistance of pathogens associated with nosocomial infections also becomes a major therapeutic challenge for physicians. Thus, the aim of this study was to identify post operative bacterial infections and determine their current antimicrobial resistance to commonly prescribed drugs.
A cross sectional study was conducted on patients under gone operation from October 2010 to January 2011 and followed for development of clinical signs and symptoms of surgical site and blood stream infection until the time of discharge. Structured questionnaire was used to collect socio demographic characteristics. Wound swab and venous blood samples were collected and processed for bacterial isolation and antimicrobial susceptibility testing following standard bacteriological techniques.
Out of 294 patients who had clean and clean-contaminated operation, 10.9% were confirmed of bacterial nosocomial infections. The rate of nosocomial infections among clean and clean-contaminated operations was 3.3% and 12.8% respectively. Nosocomial surgical site and blood stream infection rate was 10.2% and 2.4% correspondingly. A total of 42 bacterial pathogens were identified of which S. aureus was the leading isolates accounting 26.2% followed by E. coli and Coagulase negative Staphylococcus species each 21.4%. Nearly 100% of Gram positive and 95.5% of Gram negative bacterial isolates showed resistance against two or more antimicrobial drugs.
Multiple drug resistance of isolates to antimicrobials was alarmingly high so that any empirical prophylaxis and treatment needs careful selection of effective drugs. To minimize such infections, adherence of strict aseptic surgical procedures and proper management of wounds is required.
医院感染是全球主要的公共卫生问题。与医院感染相关的病原体对抗生素的耐药性不断增加,这也给医生带来了重大的治疗挑战。因此,本研究的目的是确定术后细菌感染情况,并确定其目前对常用处方药的耐药性。
对2010年10月至2011年1月接受手术的患者进行横断面研究,并跟踪手术部位和血流感染的临床症状和体征,直至出院。使用结构化问卷收集社会人口统计学特征。按照标准细菌学技术收集伤口拭子和静脉血样本,进行细菌分离和药敏试验。
在294例接受清洁和清洁-污染手术的患者中,10.9%被确诊为医院细菌性感染。清洁手术和清洁-污染手术的医院感染率分别为3.3%和12.8%。医院手术部位感染率和血流感染率分别为10.2%和2.4%。共鉴定出42种细菌病原体,其中金黄色葡萄球菌是主要分离株,占26.2%,其次是大肠杆菌和凝固酶阴性葡萄球菌,各占21.4%。近100%的革兰氏阳性菌和95.5%的革兰氏阴性菌分离株对两种或更多种抗菌药物耐药。
分离株对抗菌药物的多重耐药性高得惊人,因此任何经验性预防和治疗都需要谨慎选择有效药物。为尽量减少此类感染,需要严格遵守无菌手术程序并妥善处理伤口。