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肯尼亚西部穿皮潜蚤病患者中的继发性细菌感染与抗生素耐药性

Secondary bacterial infections and antibiotic resistance among tungiasis patients in Western, Kenya.

作者信息

Nyangacha Ruth Monyenye, Odongo David, Oyieke Florence, Ochwoto Missiani, Korir Richard, Ngetich Ronald Kiprotich, Nginya Gladys, Makwaga Olipher, Bii Christine, Mwitari Peter, Tolo Festus

机构信息

Center for Traditional Medicine and Drug Research, Kenya Medical Research Institute, Nairobi, Kenya.

School of Biological Sciences, University of Nairobi, Nairobi, Kenya.

出版信息

PLoS Negl Trop Dis. 2017 Sep 8;11(9):e0005901. doi: 10.1371/journal.pntd.0005901. eCollection 2017 Sep.

Abstract

Tungiasis or jigger infestation is a parasitic disease caused by the female sand flea Tunga penetrans. Secondary infection of the lesions caused by this flea is common in endemic communities. This study sought to shed light on the bacterial pathogens causing secondary infections in tungiasis lesions and their susceptibility profiles to commonly prescribed antibiotics. Participants were recruited with the help of Community Health Workers. Swabs were taken from lesions which showed signs of secondary infection. Identification of suspected bacteria colonies was done by colony morphology, Gram staining, and biochemical tests. The Kirby Bauer disc diffusion test was used to determine the drug susceptibility profiles. Out of 37 participants, from whom swabs were collected, specimen were positive in 29 and 8 had no growth. From these, 10 different strains of bacteria were isolated. Two were Gram positive bacteria and they were, Staphylococcus epidermidis (38.3%) and Staphylococcus aureus (21.3%). Eight were Gram negative namely Enterobacter cloacae (8.5%), Proteus species (8.5%), Klebsiellla species (6.4%), Aeromonas sobria (4.3%), Citrobacter species (4.3%), Proteus mirabillis(4.3%), Enterobacter amnigenus (2.1%) and Klebsiella pneumoniae (2.1%). The methicillin resistant S. aureus (MRSA) isolated were also resistant to clindamycin, kanamycin, erythromycin, nalidixic acid, trimethorprim sulfamethoxazole and tetracycline. All the Gram negative and Gram positive bacteria isolates were sensitive to gentamicin and norfloxacin drugs. Results from this study confirms the presence of resistant bacteria in tungiasis lesions hence highlighting the significance of secondary infection of the lesions in endemic communties. This therefore suggests that antimicrobial susceptibility testing may be considered to guide in identification of appropriate antibiotics and treatment therapy among tungiasis patients.

摘要

潜蚤病或沙蚤感染是由雌性穿皮潜蚤引起的一种寄生虫病。在流行社区,由这种跳蚤引起的病变继发感染很常见。本研究旨在阐明导致潜蚤病病变继发感染的细菌病原体及其对常用抗生素的敏感性。在社区卫生工作者的帮助下招募参与者。从有继发感染迹象的病变处采集拭子。通过菌落形态、革兰氏染色和生化试验对疑似细菌菌落进行鉴定。采用 Kirby Bauer 纸片扩散法测定药敏谱。在采集拭子的 37 名参与者中,29 份标本呈阳性,8 份无生长。从中分离出 10 种不同的细菌菌株。两种为革兰氏阳性菌,分别是表皮葡萄球菌(38.3%)和金黄色葡萄球菌(21.3%)。八种为革兰氏阴性菌,分别是阴沟肠杆菌(8.5%)、变形杆菌属(8.5%)、克雷伯菌属(6.4%)、温和气单胞菌(4.3%)、柠檬酸杆菌属(4.3%)、奇异变形杆菌(4.3%)、产氨肠杆菌(2.1%)和肺炎克雷伯菌(2.1%)。分离出的耐甲氧西林金黄色葡萄球菌(MRSA)对克林霉素、卡那霉素、红霉素、萘啶酸、甲氧苄啶磺胺甲恶唑和四环素也耐药。所有革兰氏阴性菌和革兰氏阳性菌分离株对庆大霉素和诺氟沙星敏感。本研究结果证实潜蚤病病变中存在耐药菌,从而凸显了流行社区中病变继发感染的重要性。因此,这表明在潜蚤病患者中可考虑进行抗菌药敏试验,以指导选择合适的抗生素和治疗方案。

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