Ahmed Dilruba, Nahid Md Ausrafuggaman, Sami Abdullah Bashar, Halim Farhana, Akter Nasrin, Sadique Tuhin, Rana Md Sohel, Elahi Md Shahriar Bin, Rahman Md Mahbubur
International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212 Bangladesh.
Antimicrob Resist Infect Control. 2017 Jan 5;6:2. doi: 10.1186/s13756-016-0162-z. eCollection 2017.
Bloodstream infections due to bacterial pathogens are a major cause of morbidity and mortality in Bangladesh and other developing countries. In these countries, most patients are treated empirically based on their clinical symptoms. Therefore, up to date etiological data for major pathogens causing bloodstream infections may play a positive role in better healthcare management. The aim of this study was to identify the bacterial pathogens causing major bloodstream infections in Dhaka, Bangladesh and determine their antibiotic susceptibility pattern.
From January 2005 to December 2014, a total of 103,679 single bottle blood samples were collected from both hospitalized and domiciliary patients attending Dhaka hospital, icddrb, Bangladesh All the blood samples were processed for culture using a BACT/Alert blood culture machine. Further identification of bacterial pathogens and their antimicrobial susceptibility test were performed using standard microbiological procedures.
Overall, 13.6% of the cultured blood samples were positive and Gram-negative (72.1%) bacteria were predominant throughout the study period. Typhi was the most frequently isolated organism (36.9% of samples) in this study and a high percentage of those strains were multidrug-resistant (MDR). However, a decreasing trend in the . Typhi isolation rate was observed and, noticeably, the percentage of MDR isolated declined sharply over the study period. An overall increase in the presence of Gram-positive bacteria was observed, but most significantly we observed the percentage of MDR Gram-positive bacteria to double over the study period. Overall, Gram positive bacteria were more resistant to most of the commonly used antibiotics than Gram-negative bacteria, but the MDR level was high in both groups.
This study identified the major bacterial pathogens involved with BSI in Dhaka, Bangladesh and also revealed their antibiotic susceptibility patterns. We expect our findings to help healthcare professionals to make informed decisions and provide better care for their patients. Also, we hope this study will assist researchers and policy makers to prioritize their research options to face the future challenges of infectious diseases.
在孟加拉国和其他发展中国家，由细菌病原体引起的血流感染是发病和死亡的主要原因。在这些国家，大多数患者根据临床症状接受经验性治疗。因此，关于引起血流感染的主要病原体的最新病因数据可能在更好的医疗管理中发挥积极作用。本研究的目的是确定孟加拉国达卡引起主要血流感染的细菌病原体，并确定其抗生素敏感性模式。
2005年1月至2014年12月，从孟加拉国达卡医院、icddrb的住院患者和居家患者中总共采集了103679份单瓶血样。所有血样均使用BACT/Alert血培养仪进行培养处理。使用标准微生物学程序对细菌病原体进行进一步鉴定及其抗菌药敏试验。
总体而言，13.6%的培养血样呈阳性，在整个研究期间革兰氏阴性菌（72.1%）占主导。伤寒杆菌是本研究中最常分离出的病原体（占样本的36.9%），且这些菌株中有很大比例是多重耐药菌（MDR）。然而，观察到伤寒杆菌的分离率呈下降趋势，值得注意的是，在研究期间分离出的多重耐药菌的比例急剧下降。观察到革兰氏阳性菌的总体占比有所增加，但最显著的是，我们观察到多重耐药革兰氏阳性菌的比例在研究期间翻了一番。总体而言，革兰氏阳性菌比革兰氏阴性菌对大多数常用抗生素更耐药，但两组的多重耐药水平都很高。
本研究确定了孟加拉国达卡与血流感染相关的主要细菌病原体，并揭示了它们的抗生素敏感性模式。我们期望我们的研究结果能帮助医疗专业人员做出明智的决策，并为他们的患者提供更好的护理。此外，我们希望这项研究将帮助研究人员和政策制定者确定其研究重点，以应对传染病未来的挑战。
