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手术部位感染的细菌学特征及其抗菌谱:来自印度北阿坎德邦资源有限农村地区的一项研究

Bacteriological Profile of Surgical Site Infections and Their Antibiogram: A Study From Resource Constrained Rural Setting of Uttarakhand State, India.

作者信息

Negi Vikrant, Pal Shekhar, Juyal Deepak, Sharma Munesh Kumar, Sharma Neelam

机构信息

Former Junior Demonstrator, Department of Microbiology and Immunology, Veer Chandra Singh Garhwali Government Medical Sciences and Research Institute , Srinagar Garhwal, Uttarakhand, India .

Associate Professor, Department of Microbiology and Immunology, Veer Chandra Singh Garhwali Government Medical Sciences and Research Institute , Srinagar Garhwal, Uttarakhand, India .

出版信息

J Clin Diagn Res. 2015 Oct;9(10):DC17-20. doi: 10.7860/JCDR/2015/15342.6698. Epub 2015 Oct 1.

Abstract

INTRODUCTION

Surgical site infections (SSI) constitute a major public health problem worldwide and are the second most frequently reported nosocomial infections. They are responsible for increasing the treatment cost, length of hospital stay and significant morbidity and mortality.

AIM

To determine the incidence of SSIs and the prevalence of aerobic bacterial pathogens involved with their antibiogram.

MATERIALS AND METHODS

Samples were collected using sterile cotton swabs from 137 patients clinically diagnosed of having SSIs and were processed as per standard microbiological techniques. Antimicrobial susceptibility testing was done using modified Kirby-Bauer disc diffusion method. This cross sectional study was conducted for a period of six months (January 2013 to June 2013) in the Department of Microbiology at a rural tertiary care hospital of Uttarakhand state, India.

RESULTS

Out of 768 patients, 137 (17.8%) were found to have SSIs and samples were collected from them. Out of total 137 samples, 132 (96.4%) yielded bacterial growth and 139 bacterial isolates were obtained. Staphylococcus aureus (50.4%) was the commonest organism followed by Escherichia coli (23.02%), Pseudomonas aeruginosa (7.9%) and Citrobacter species (7.9%). Antimicrobial profile of gram positive isolates revealed maximum sensitivity to vancomycin, teicoplanin and linezolid, whereas among gram negative isolates meropenem, piperacillin-tazobactam, and amikacin were found to be most sensitive.

CONCLUSION

The rate of SSI observed in this study was comparable to other similar studies, however we observed a higher degree of antimicrobial resistance. Adherence to strict infection control measures, maintenance of proper hand hygiene and optimal preoperative, intraoperative and postoperative patient care will surely reduce the incidence of SSIs.

摘要

引言

手术部位感染(SSI)是全球范围内的一个主要公共卫生问题,是第二常见的医院感染。它们会增加治疗成本、延长住院时间,并导致显著的发病率和死亡率。

目的

确定手术部位感染的发生率以及与其抗菌谱相关的需氧细菌病原体的流行情况。

材料与方法

使用无菌棉拭子从137例临床诊断为手术部位感染的患者中采集样本,并按照标准微生物技术进行处理。采用改良的 Kirby-Bauer 纸片扩散法进行药敏试验。这项横断面研究于2013年1月至2013年6月在印度北阿坎德邦一家农村三级护理医院的微生物科进行了六个月。

结果

在768例患者中,发现137例(17.8%)患有手术部位感染,并从他们身上采集了样本。在总共137个样本中,132个(96.4%)培养出细菌生长,共获得139株细菌分离株。金黄色葡萄球菌(50.4%)是最常见的病原体,其次是大肠杆菌(23.02%)、铜绿假单胞菌(7.9%)和柠檬酸杆菌属(7.9%)。革兰氏阳性分离株的抗菌谱显示对万古霉素、替考拉宁和利奈唑胺的敏感性最高,而在革兰氏阴性分离株中,美罗培南、哌拉西林-他唑巴坦和阿米卡星最敏感。

结论

本研究中观察到的手术部位感染率与其他类似研究相当,然而我们观察到更高程度的抗菌耐药性。坚持严格的感染控制措施、保持适当的手部卫生以及优化术前、术中和术后的患者护理肯定会降低手术部位感染的发生率。

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