Olufunmiso Olajuyigbe, Tolulope Ikpehae, Roger Coopoosamy
Department of Microbiology, School of Sciences and Technology, Babcock University, PMB 4005, Ilisan-Remo, Ogun State, Nigeria.
Department of Nature Conservation, Faculty of Natural Sciences, Mangosuthu University of Technology, Durban, South Africa.
Afr Health Sci. 2017 Sep;17(3):797-807. doi: 10.4314/ahs.v17i3.23.
has emerged as a major public health concern because of the occurrence of multi-drug resistant strains. This study aimed at investigating the multi-drug and vancomycin resistance profile of from different infection sites in some teaching hospitals in Nigeria.
Swabs were collected from different infection sites from out-patients in three teaching hospitals from October 2015 to May, 2016. The antibiotic-susceptibility test was carried out with selected antibiotics usually administered anti-microbials in the treatment of infections in these hospitals. The prevalence of multi-drug and vancomycin resistance strains of from clinical samples was determined using disk diffusion and agar dilution methods respectively.
The result showed (165)82.5% of the isolates were resistant to ≥3 antibiotics tested. They were highly resistant to ceftazidime 180(90%), cloxacillin 171(85.6%) and augmentin 167(83.3%), but susceptible to ofloxacin 150(75%), gentamicin 142(71.7%), erythromycin 122(61.1%), ceftriaxone 111(55.6%) and cefuroxime 103(51.7%). All the isolates from the HVS were all multidrug resistant strains. While (56)90.16% were multidrug resistant (MDR) in urine samples, followed by (8)88.89% MDR strains in sputum, (37)88.81% MDR strains in semen, (49)71.64% MDR strains in wounds and (6)60% MDR strains in ear swabs samples. Although (147)73.5% of the isolates were vancomycin susceptible (VSSA), (30)15% were vancomycin intermediate resistant (VISA) and (89)44.5% of the isolates were considered vancomycin resistant (VRSA).
The high percentage of the VRSA could have resulted from compromising treatment options and inadequate antimicrobial therapy. The implication, infections caused by VRSA would be difficult to treat with vancomycin and other effective antibiotics of clinical importance. Ensuring proper monitoring of drug administration will, therefore, enhance the legitimate role of vancomycin as an empiric choice for both prophylaxis against and treatment of infections.
由于多重耐药菌株的出现，[具体细菌名称未给出]已成为一个主要的公共卫生问题。本研究旨在调查尼日利亚一些教学医院不同感染部位的[具体细菌名称未给出]对多种药物及万古霉素的耐药情况。
2015年10月至2016年5月，从三家教学医院的门诊患者不同感染部位采集拭子。使用这些医院治疗感染时常用的选定抗生素进行药敏试验。分别采用纸片扩散法和琼脂稀释法测定临床样本中[具体细菌名称未给出]的多重耐药和万古霉素耐药菌株的流行情况。
结果显示，165株（82.5%）分离株对≥3种测试抗生素耐药。它们对头孢他啶耐药率高，为180株（90%），对氯唑西林耐药率为171株（85.6%），对阿莫西林/克拉维酸耐药率为167株（83.3%），但对氧氟沙星敏感率为150株（75%），对庆大霉素敏感率为142株（71.7%），对红霉素敏感率为122株（61.1%），对头孢曲松敏感率为111株（55.6%），对头孢呋辛敏感率为103株（51.7%）。所有来自高阴道拭子（HVS）的分离株均为多重耐药菌株。尿液样本中56株（90.16%）为多重耐药（MDR）菌株，其次是痰液中8株（88.89%）MDR菌株，精液中37株（88.81%）MDR菌株，伤口中49株（71.64%）MDR菌株，耳拭子样本中6株（60%）MDR菌株。虽然147株（73.5%）分离株对万古霉素敏感（VSSA），30株（15%）为万古霉素中介耐药（VISA），89株（44.5%）分离株被认为对万古霉素耐药（VRSA）。
VRSA的高比例可能是由于治疗选择受限和抗菌治疗不足导致的。这意味着，由VRSA引起的感染很难用万古霉素和其他具有临床重要性的有效抗生素治疗。因此，确保对药物使用进行适当监测将增强万古霉素作为预防和治疗[具体细菌名称未给出]感染的经验性选择的合理作用。
