Das Sumon Kumar, Ahmed Shahnawaz, Ferdous Farzana, Farzana Fahmida Dil, Chisti Mohammod Jobayer, Latham Jonathan Ross, Talukder Kaisar Ali, Rahman Mustafizur, Begum Yasmin Ara, Qadri Firdausi, Faruque Abu Syed Golam, Ahmed Tahmeed
International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
J Infect Dev Ctries. 2013 Dec 15;7(12):900-9. doi: 10.3855/jidc.3003.
This study compared the diversity of common diarrhoeal pathogens and antimicrobial susceptibility in four hospitals in Bangladesh.
A total of 13,959 diarrhoea patients, comprising rural Mirzapur (2,820), rural Matlab (2,865), urban Dhaka (5,287) and urban Mirpur (2,987) were included under the diarrhoeal disease surveillance system of icddr,b during 2010-2011; stool specimens were tested for Shigella spp., Vibrio cholerae, enterotoxigenic Escherichia coli and rotavirus.
Rotavirus was highest in Mirzapur (28%) followed by Dhaka (24%), Matlab (19%) and Mirpur (18%). Overall, Shigella was significantly more prevalent in rural sites (Mirzapur 13% and Matlab 7%), than in urban sites (Dhaka 3% and Mirpur 3%). Vibrio cholerae was more common in the urban sites of Dhaka (14%) and Mirpur (12%). 72% of Shigella isolates were susceptible to ciprofloxacin in Mirzapur, and 88% to mecillinam. In Dhaka, the figures for Shigella were 65% and 50%, in Matlab 65% and 85%, and in Mirpur 59% and 92% respectively. Susceptibility of Shigella to azithromycin and ceftriaxone in Dhaka was 74% and 95%, and in Mirpur 88% and 92% respectively. Vibrio cholerae showed the highest resistance to trimethoprim-sulfamethoxazole (100% in Mirpur) and lowest resistance to ciprofloxacin (0% in Dhaka, Matlab and Mirpur) and azithromycin (30% in Dhaka to 7% in Mirzapur). Multidrug resistance (≥3 antibiotics) for Shigella were: Mirzapur (50%); Dhaka (36%); Matlab (23%) and Mirpur (37%); and for V. cholerae it was 26%, 37%, 49% and 23% respectively.
The isolation rates and antimicrobial susceptibility of Shigella spp. and V. cholerae along with rotavirus differed significantly in certain geographical sites.
本研究比较了孟加拉国四家医院常见腹泻病原体的多样性及抗菌药物敏感性。
在2010 - 2011年期间，国际腹泻病研究中心孟加拉国分中心的腹泻病监测系统纳入了总共13959例腹泻患者，包括来自农村米尔扎布尔（2820例）、农村马特莱布（2865例）、达卡市（5287例）和米尔布尔市（2987例）的患者；对粪便标本进行志贺菌属、霍乱弧菌、产肠毒素大肠埃希菌和轮状病毒检测。
轮状病毒在米尔扎布尔检出率最高（28%），其次是达卡（24%）、马特莱布（19%）和米尔布尔（18%）。总体而言，志贺菌在农村地区（米尔扎布尔13%，马特莱布7%）的流行率显著高于城市地区（达卡3%，米尔布尔3%）。霍乱弧菌在达卡（14%）和米尔布尔（12%）的城市地区更为常见。米尔扎布尔72%的志贺菌分离株对环丙沙星敏感，88%对美西林敏感。在达卡，志贺菌对这两种药物的敏感率分别为65%和50%；在马特莱布为65%和85%；在米尔布尔为59%和92%。达卡志贺菌对阿奇霉素和头孢曲松的敏感率分别为74%和95%，米尔布尔分别为88%和92%。霍乱弧菌对复方新诺明耐药率最高（米尔布尔为100%），对环丙沙星耐药率最低（达卡、马特莱布和米尔布尔均为0%），对阿奇霉素耐药率在达卡为30%至米尔扎布尔的7%。志贺菌的多重耐药（≥3种抗生素）情况为：米尔扎布尔（50%）；达卡（36%）；马特莱布（23%）；米尔布尔（37%）；霍乱弧菌的多重耐药率分别为26%、37%、49%和23%。
志贺菌属、霍乱弧菌以及轮状病毒的分离率和抗菌药物敏感性在某些地理区域存在显著差异。
