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一家三级护理医院中伤寒沙门氏菌和甲型副伤寒沙门氏菌的药敏模式

Antimicrobial susceptibility patterns of Salmonella typhi and Salmonella paratyphi A in a tertiary care hospital.

作者信息

Raza S, Tamrakar R, Bhatt C P, Joshi S K

机构信息

Department of Microbiology, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal.

出版信息

J Nepal Health Res Counc. 2012 Sep;10(22):214-7.

Abstract

BACKGROUND

Enteric fever is still an important public health problem in developing countries including Nepal. A changing antibiotic susceptibility pattern of Salmonella typhi and Salmonella paratyphi A and emergence of multi drug resistance has increased to a great concern. Aim of the study was to investigate the antibiotic susceptibility pattern of Salmonella typhi and Salmonella paratyphi A.

METHODS

Study was carried out at the department of microbiology in Kathmandu Medical College. Blood culture samples were collected from suspected enteric fever patient and tested microbiologically by standard procedure. Antibiotic susceptibility test was performed by Kirby-Bauer disc diffusion method and results were interpreted by National Committee for Clinical Laboratory (NCCLS) guideline.

RESULTS

Of total 78 (2.0%) Salmonella serotype isolated from 3,980 blood culture samples, in which 47 (60.3%) were S. typhi and 31 (39.7%) were S. paratyphi A. Isolates were from all age group median age being the 25 years. Among the tested antibiotics S. typhi was susceptible towards Ciprofloxacin (100%) followed by Gentamicin (97.9%), Ofloxacine (95.7%), Ceftriaxone (95.7%) and Chloramphenicol (93.6%). In case of S. paratyphi A most of the tested antibiotics showed high percentage of susceptibility and least susceptible antibiotic for S. paratyphi A was Ampicillin (25.8%). Three isolates of S. typhi showed multidrug resistance.

CONCLUSIONS

A considerable variation was observed in the antimicrobial susceptibility pattern of S.typhi and S. paratyphi A. Hence antibiotic susceptibility test must be sought before instituting appropriate therapy to prevent from further emergence of drug resistance.

摘要

背景

在包括尼泊尔在内的发展中国家,伤寒仍然是一个重要的公共卫生问题。伤寒沙门氏菌和甲型副伤寒沙门氏菌不断变化的抗生素敏感性模式以及多重耐药性的出现引起了极大关注。本研究的目的是调查伤寒沙门氏菌和甲型副伤寒沙门氏菌的抗生素敏感性模式。

方法

研究在加德满都医学院微生物学系进行。从疑似伤寒患者采集血培养样本,并通过标准程序进行微生物检测。采用 Kirby-Bauer 纸片扩散法进行抗生素敏感性试验,结果依据美国国家临床实验室标准委员会(NCCLS)指南进行解读。

结果

从 3980 份血培养样本中分离出的 78 株(2.0%)沙门氏菌血清型中,47 株(60.3%)为伤寒沙门氏菌,31 株(39.7%)为甲型副伤寒沙门氏菌。分离株来自所有年龄组,中位年龄为 25 岁。在测试的抗生素中,伤寒沙门氏菌对环丙沙星(100%)敏感,其次是庆大霉素(97.9%)、氧氟沙星(95.7%)、头孢曲松(95.7%)和氯霉素(93.6%)。对于甲型副伤寒沙门氏菌,大多数测试抗生素显示出较高的敏感性百分比,对甲型副伤寒沙门氏菌最不敏感的抗生素是氨苄西林(25.8%)。3 株伤寒沙门氏菌分离株显示出多重耐药性。

结论

观察到伤寒沙门氏菌和甲型副伤寒沙门氏菌的抗菌药物敏感性模式存在相当大的差异。因此,在进行适当治疗之前必须进行抗生素敏感性试验,以防止耐药性的进一步出现。

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