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埃塞俄比亚德布雷马科斯转诊医院患者不同部位感染的细菌病原体及抗生素耐药情况:一项横断面研究

Bacterial agents and antibiotic resistance profiles of infections from different sites that occurred among patients at Debre Markos Referral Hospital, Ethiopia: a cross-sectional study.

作者信息

Mulu Wondemagegn, Abera Bayeh, Yimer Mulat, Hailu Tadesse, Ayele Haimanot, Abate Dereje

机构信息

Department of Medical Microbiology, Immunology and Parasitology, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia.

Department of Microbiology Laboratory, Debre Markos Referral Hospital, Debre Markos, Ethiopia.

出版信息

BMC Res Notes. 2017 Jul 6;10(1):254. doi: 10.1186/s13104-017-2584-y.

Abstract

BACKGROUND

In developing countries like Ethiopia, infections with antibiotic resistant bacteria become a real threat. Hence, monitoring of local level antimicrobial resistance profile is indispensable to contain the spread of drug resistant bacteria and intervene poor awareness on antimicrobial resistance. Therefore, this study aimed at determining bacterial and antibiotic resistance profiles of infections from different sites that occurred among patients.

METHODS

Retrospective data recorded were analyzed on culture and drug susceptibility test results at Debre Markos Referral Hospital which were performed from 2011 to 2014. Drug susceptibility tests were performed using disk-diffusion technique. Chi square test was computed to compare the proportion of bacterial isolates with patients' age and sex.

RESULTS

Out of 575 clinical samples processed, 280 (48.7%) were culture positive for aerobic bacteria pathogens. Wound 238 (41.4%) and urine 108 (18.8%) were the most frequent samples processed. Overall, Staphylococcus aureus (S. aureus) was the predominant isolate 100 (31.5%) followed by Escherichia coli (E. coli) 39 (13.8%), Pseudomonas aeruginosa (P. aeruginosa) 30 (10.3%) and Salmonella spp. 25 (8.9%). P. aeruginosa was the most frequent isolate followed by S. aureus from ear infection. E. coli was the leading isolate followed by Klebsiella spp. from urinary tract infection. Salmonella and Shigella spp. were the most frequent isolates in stool in children below 5 years of age. Neisseria gonorrhoeae (N. gonorrhoeae) 16 (76.2%) was the most common isolate from urethral discharge. The overall multidrug-resistant Gram positive and Gram negative bacteria isolates were 113 (84.6%) and 96 (72.2%), respectively. Gram positive bacteria revealed resistance to cotrimoxazole (80%), gentamicin (83.1%), amoxicillin (85.1%), ampicillin (85.8%), penicillin (89.7%), clindamycin (93.2%) and erythromycin (90.9%). Gram negative bacteria showed resistance to cotrimoxazole (53.1%), amoxicillin (58.8%), ampicillin (70.4%), tetracycline (75.9%) and gentamicin (76.9%).

CONCLUSIONS

Various bacterial infections linked with high levels of MDR bacteria pathogens are major health problems in the study area. Therefore, treatment of common bacterial infections in the study area needs to be guided by drug-susceptibility testing of isolates.

摘要

背景

在埃塞俄比亚这样的发展中国家,抗生素耐药菌感染成为了一个现实威胁。因此,监测当地层面的抗菌药物耐药情况对于遏制耐药菌的传播以及纠正对抗菌药物耐药性的认识不足至关重要。所以,本研究旨在确定患者中不同部位感染的细菌及抗生素耐药情况。

方法

对德布雷马科斯转诊医院2011年至2014年进行的培养及药敏试验结果的回顾性数据进行分析。药敏试验采用纸片扩散法。计算卡方检验以比较细菌分离株比例与患者年龄和性别的关系。

结果

在处理的575份临床样本中,280份(48.7%)需氧菌病原体培养呈阳性。伤口样本238份(41.4%)和尿液样本108份(18.8%)是处理最多的样本。总体而言,金黄色葡萄球菌是主要分离株,有100株(31.5%),其次是大肠埃希菌39株(13.8%)、铜绿假单胞菌30株(10.3%)和沙门菌属25株(8.9%)。耳部感染中,铜绿假单胞菌是最常见的分离株,其次是金黄色葡萄球菌。泌尿系统感染中,大肠埃希菌是主要分离株,其次是克雷伯菌属。5岁以下儿童粪便中,沙门菌属和志贺菌属是最常见的分离株。尿道分泌物中,淋病奈瑟菌16株(76.2%)是最常见的分离株。革兰氏阳性和革兰氏阴性细菌的总体多重耐药分离株分别为113株(84.6%)和96株(72.2%)。革兰氏阳性菌对复方新诺明(80%)、庆大霉素(83.1%)、阿莫西林(85.1%)、氨苄西林(85.8%)、青霉素(89.7%)、克林霉素(93.2%)和红霉素(90.9%)耐药。革兰氏阴性菌对复方新诺明(53.1%)、阿莫西林(58.8%)、氨苄西林(70.4%)、四环素(75.9%)和庆大霉素(76.9%)耐药。

结论

与高水平多重耐药菌病原体相关的各种细菌感染是研究区域的主要健康问题。因此,研究区域常见细菌感染的治疗需要依据分离株的药敏试验结果来指导。

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