Hout Boren, Oum Chamroeun, Men Putheavy, Vanny Vanvathanak, Supaprom Chonthida, Heang Vireak, Rachmat Agus, Prouty Michael, Newell Steven, Harrison Dustin, Noor Saqib, Gollogly James, Tho Ly, Kim Yong June, Ford Gavin
Naval Medical Research Unit - No.2, Phnom Penh, Cambodia.
Children's Surgical Center, Phnom Penh, Cambodia.
Trop Dis Travel Med Vaccines. 2015 Jul 31;1:4. doi: 10.1186/s40794-015-0006-5. eCollection 2015.
Emerging antibiotic resistance amongst clinically significant bacteria is a public health issue of increasing significance worldwide, but it is relatively uncharacterized in Cambodia. In this study we performed standard bacterial cultures on samples from wounds at a Non-Governmental-Organization (NGO) Hospital in Phnom Penh, Cambodia. Testing was performed to elucidate pathogenic bacteria causing wound infections and the antibiotic resistance profiles of bacterial isolates. All testing was performed at the Naval Medical Research Unit, No.2 (NAMRU-2) main laboratory in Phnom Penh, Cambodia.
Between 2011-2013, a total of 251 specimens were collected from patients at the NGO hospital and analyzed for bacterial infection by standard bacterial cultures techniques. Specimens were all from wounds and anonymous. No specific clinical information accompanied the submitted specimens. Antibiotic susceptibility testing, and phenotypic testing for extended-spectrum beta-lactamase (ESBL) were performed and reported based on CLSI guidelines. Further genetic testing for CTX-M, TEM and SHV ESBLs was accomplished using PCR.
One-hundred and seventy-six specimens were positive following bacterial culture (70 %). was the most frequently isolated bacteria. Antibiotic drug resistance testing revealed that 52.5 % of isolates were oxacillin resistant. For isolates, 63.9 % were ciprofloxacin and levofloxacin resistant and 96 % were ESBL producers. Resistance to meropenem and imipenem was observed in one of three isolates.
This study is the first of its kind detailing the antibiotic resistance profiles of pathogenic bacteria causing wound infections at a single surgical hospital in Cambodia. The reported findings of this study demonstrate significant antibiotic resistance in bacteria from injured patients and should serve to guide treatment modalities in Cambodia.
临床上重要细菌中不断出现的抗生素耐药性是一个在全球范围内日益重要的公共卫生问题,但在柬埔寨相对缺乏相关特征描述。在本研究中,我们对柬埔寨金边一家非政府组织医院伤口样本进行了标准细菌培养。进行检测以阐明引起伤口感染的病原菌及细菌分离株的抗生素耐药谱。所有检测均在柬埔寨金边海军医学研究第二分队(NAMRU - 2)的主要实验室进行。
2011年至2013年期间,共从该非政府组织医院的患者中收集了251份标本,并通过标准细菌培养技术分析细菌感染情况。标本均来自伤口且匿名。提交的标本未附带具体临床信息。根据临床和实验室标准协会(CLSI)指南进行抗生素敏感性检测以及超广谱β - 内酰胺酶(ESBL)的表型检测并报告结果。使用聚合酶链反应(PCR)对CTX - M、TEM和SHV ESBLs进行进一步基因检测。
细菌培养后176份标本呈阳性(70%)。 是最常分离出的细菌。抗生素耐药性检测显示,52.5%的 分离株对苯唑西林耐药。对于 分离株,63.9%对环丙沙星和左氧氟沙星耐药,96%是ESBL产生菌。在三份 分离株中有一份对美罗培南和亚胺培南耐药。
本研究是首次详细描述柬埔寨一家单一外科医院中引起伤口感染的病原菌抗生素耐药谱。本研究报告的结果表明受伤患者的细菌存在显著抗生素耐药性,应为柬埔寨的治疗方式提供指导。