埃塞俄比亚阿姆哈拉地区德布雷马科斯转诊医院手术部位感染患者金黄色葡萄球菌的分离及药敏模式。
Isolation and antimicrobial susceptibility pattern of Staphylococcus aureus in patients with surgical site infection at Debre Markos Referral Hospital, Amhara Region, Ethiopia.
机构信息
Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia ; School of Medicine, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
School of Medicine, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia ; Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
出版信息
Arch Public Health. 2014 May 28;72(1):16. doi: 10.1186/2049-3258-72-16. eCollection 2014.
BACKGROUND
Staphylococcus aureus, especially Methicillin Resistant Staphylococcus Aureus (MRSA) is a major health problem recognized as the most important nosocomial pathogen, often causing postoperative wound infections. Antibiotic resistance by MRSA has grown to be common, and resistance to almost all antibiotics has been found among these strains. The aim of this study was to determine the prevalence, antimicrobial susceptibility patterns and associated risk factors of S. aureus in patients with surgical site infections in an Ethiopian hospital.
METHODS
A cross-sectional study was conducted from December 1, 2011 to March 30, 2012 among patients with surgical site infections at Debre Markos Referral Hospital, Debre Markos, Ethiopia. All wound swabs obtained from patients with surgical site infections during the study period were cultured on mannitol salt agar media which is selective for S. aureus. Isolated strains of S. aureus were tested for antibiotic susceptibility patterns using standard disc diffusion technique, and interpretation of resistance was done based on Clinical and Laboratory Standard Institute criteria. Univariate and multivariable analyses were used to assess the risk factors.
RESULTS
Of the 184 surgical patients who had developed surgical site infection, S. aureus was isolated from 73 (39.7%) cases. Out of the 73 isolates of S. aureus, 36 (49.7%) were MRSA. Among the study participants, prevalence of MRSA was found to be 19.6%. The clinical isolates showed >80% level of resistance to ampicillin, amoxicillin, penicillin G, erythromycin, gentamicin and cotrimoxazole whereas <50% level of resistance was observed against clindamycin, oxacillin, tetracycline and vancomycin. MRSA strains showed resistance ranging from 5.6% (vancomycin) to 100% (cotrimoxazole). Of the following risk factors: sex, age, pus consistency, duration of operation, type of surgery, ward and hospital stay, laparotomy type of surgery was identified as a risk factor for infection by S. aureus.
CONCLUSION
The prevalence of S. aureus and/or MRSA infection in surgical and gynaecology & obstetrics wards of Debre Markos Referral Hospital was found to be high. The majority of isolates were highly resistant to major antimicrobial agents.
背景
金黄色葡萄球菌，尤其是耐甲氧西林金黄色葡萄球菌（MRSA），是一个严重的健康问题，被认为是最重要的医院病原体，常导致术后伤口感染。MRSA 的抗生素耐药性已经变得很普遍，并且在这些菌株中发现几乎对所有抗生素都有耐药性。本研究旨在确定埃塞俄比亚一家医院外科部位感染患者中金黄色葡萄球菌的流行率、抗生素敏感性模式以及相关危险因素。
方法
2011 年 12 月 1 日至 2012 年 3 月 30 日，在德布雷马科斯转诊医院（德布雷马科斯，埃塞俄比亚）对外科部位感染患者进行了横断面研究。在研究期间，从所有患有外科部位感染的患者中采集伤口拭子，接种于甘露醇盐琼脂培养基，该培养基对金黄色葡萄球菌具有选择性。使用标准纸片扩散技术测试分离的金黄色葡萄球菌的抗生素敏感性模式，根据临床和实验室标准协会（CLSI）标准进行耐药性解释。采用单变量和多变量分析评估危险因素。
结果
在 184 名发生外科部位感染的手术患者中，有 73 例（39.7%）分离出金黄色葡萄球菌。在 73 株金黄色葡萄球菌分离株中，有 36 株（49.7%）为耐甲氧西林金黄色葡萄球菌。在研究参与者中，耐甲氧西林金黄色葡萄球菌的检出率为 19.6%。临床分离株对氨苄西林、阿莫西林、青霉素 G、红霉素、庆大霉素和复方新诺明的耐药率>80%，而对克林霉素、苯唑西林、四环素和万古霉素的耐药率<50%。耐甲氧西林金黄色葡萄球菌株的耐药率范围为 5.6%（万古霉素）至 100%（复方新诺明）。在以下危险因素中：性别、年龄、脓液稠度、手术持续时间、手术类型、病房和住院时间，剖腹手术被确定为金黄色葡萄球菌感染的危险因素。
结论
在德布雷马科斯转诊医院的外科和妇产科病房中，金黄色葡萄球菌和/或耐甲氧西林金黄色葡萄球菌感染的流行率很高。大多数分离株对主要抗菌药物高度耐药。
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