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埃塞俄比亚西北部贡德尔大学教学医院接受产后保健服务的女性的细菌谱、抗菌药物耐药模式及相关因素

Bacterial Profile, Antibacterial Resistance Pattern, and Associated Factors from Women Attending Postnatal Health Service at University of Gondar Teaching Hospital, Northwest Ethiopia.

作者信息

Bitew Kifilie Abebaw, Dagnew Mulat, Tegenie Birhanemeskel, Yeshitela Biruk, Howe Rawleigh, Abate Ebba

机构信息

Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

Department of Medical Microbiology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.

出版信息

Int J Microbiol. 2018 Feb 25;2018:3165391. doi: 10.1155/2018/3165391. eCollection 2018.

Abstract

INTRODUCTION

Surgical site infection is a vital cause of maternal mortality and morbidity, especially in resource-limited countries. The rise of antibiotic resistance bacterial infection poses a big threat to this vulnerable population. However, there is lack of studies around the study area.

OBJECTIVE

The purpose of this study was to identify bacterial profile, antibacterial resistance pattern, and associated factors among mothers attending postnatal care health service.

METHODS

Institutional based cross-sectional study was conducted on 107 study participants at University of Gondar Teaching Hospital from 1 January 2016 to 30 May 2016. Wound swab, aspirate, and biopsy were collected and performed for culture and drug resistance testing. Data were entered and analyzed by using SPSS version 20. Bivariate and multivariate logistic regression models were fitted to determine the associated factors for bacterial infection. Odds ratio (95% CI) was calculated to determine the strength of statistically significant associated factors.

RESULT

Bacterial growth was confirmed in 90 (84.1%) of 107 study participants suspected to have surgical site infection. The predominant bacterial isolates were (41.6%), (19.8%), (13.9%), (12.9%), and spp. (4%). The majority of isolates were resistant to ampicillin, amoxicillin, and tetracycline but susceptible to ceftriaxone and amikacin. Multidrug-resistant bacteria species were isolated. Using a procedure such as cesarean section and episiotomy for delivery and premature rapture of membrane had strong association with bacterial infection.

CONCLUSION

The high prevalence of bacterial profile and isolation of multidrug-resistant bacteria pose a big threat to postnatal mothers and their children. Factors such as cesarean section, episiotomy for delivery, and premature rapture of membrane were predictors for bacterial infection. Therefore, there should be done a continuous surveillance as well as rational use of antibiotics and a longitudinal study using phenotypic and genotypic methods will be done.

摘要

引言

手术部位感染是孕产妇发病和死亡的重要原因,尤其是在资源有限的国家。抗生素耐药细菌感染的增加对这一弱势群体构成了巨大威胁。然而,研究区域周围缺乏相关研究。

目的

本研究的目的是确定接受产后护理健康服务的母亲中的细菌谱、抗菌药物耐药模式及相关因素。

方法

2016年1月1日至2016年5月30日,在贡德尔大学教学医院对107名研究参与者进行了基于机构的横断面研究。收集伤口拭子、吸出物和活检样本进行培养和耐药性检测。使用SPSS 20版录入和分析数据。采用二元和多元逻辑回归模型确定细菌感染的相关因素。计算比值比(95%可信区间)以确定具有统计学意义的相关因素的强度。

结果

107名疑似手术部位感染的研究参与者中,90名(84.1%)证实有细菌生长。主要的细菌分离株为[具体细菌名称1](41.6%)、[具体细菌名称2](19.8%)、[具体细菌名称3](13.9%)、[具体细菌名称4](12.9%)和[具体细菌名称5]属(4%)。大多数分离株对氨苄西林、阿莫西林和四环素耐药,但对头孢曲松和阿米卡星敏感。分离出了多重耐药细菌种类。采用剖宫产和会阴切开术等分娩方式以及胎膜早破与细菌感染密切相关。

结论

细菌谱的高流行率和多重耐药细菌的分离对产后母亲及其子女构成了巨大威胁。剖宫产、分娩时会阴切开术和胎膜早破等因素是细菌感染的预测因素。因此,应持续进行监测以及合理使用抗生素,并将采用表型和基因型方法进行纵向研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d823/5845495/387ed3ed2934/IJMICRO2018-3165391.001.jpg

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