Kazimoto Theckla, Abdulla Salim, Bategereza Leah, Juma Omar, Mhimbira Francis, Weisser Maja, Utzinger Jürg, von Müller Lutz, Becker Sören L
Ifakara Health Institute, Bagamoyo Branch, P.O. Box 74, Bagamoyo, Tanzania; Institute of Medical Microbiology and Hygiene, Saarland University, Kirrberger Straße, Building 43, 66421 Homburg/Saar, Germany.
Ifakara Health Institute, Bagamoyo Branch, P.O. Box 74, Bagamoyo, Tanzania.
Acta Trop. 2018 Oct;186:102-106. doi: 10.1016/j.actatropica.2018.07.007. Epub 2018 Jul 10.
Few epidemiological studies have been carried out to assess the aetiology and antimicrobial susceptibility patterns of pathogens giving rise to skin and soft tissue infections (SSTIs) in sub-Saharan Africa. In the present study from six healthcare facilities in Bagamoyo, Tanzania, wound swabs from outpatients with SSTIs were analysed by a suite of methods, including microbiological culture techniques, matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry and resistance testing. Among 185 patients with SSTIs, 179 (96.8%) swabs showed microbiological growth. In total, 327 organisms were found, of which 285 were of potential aetiological relevance. Staphylococcus aureus was the predominant pathogen (prevalence: 71.4%), followed by the Gram-negative bacteria Enterobacter cloacae complex (14.6%), Klebsiella pneumoniae (12.4%) and Pseudomonas aeruginosa (11.8%). While one out of three isolates of S. aureus showed resistance to macrolides, tetracyclines, cotrimoxazole and clindamycin, only a single methicillin-resistant S. aureus (MRSA) strain was found. In Gram-negative bacteria, resistance to ampicillin and cotrimoxazole was common, while extended-spectrum beta-lactamases were rarely detected (<1%). We conclude that S. aureus was the most frequently detected pathogen in community-acquired SSTIs in Bagamoyo, Tanzania. Resistance to commonly prescribed oral antibiotics was considerable, but multi-resistant strains were rarely encountered. Monitoring of antibiotic susceptibility patterns in SSTIs is important to provide specific data for tailoring treatment recommendations.
在撒哈拉以南非洲地区，很少有流行病学研究评估引发皮肤和软组织感染（SSTIs）的病原体的病因及抗菌药物敏感性模式。在坦桑尼亚巴加莫约的六个医疗机构开展的本研究中，采用了包括微生物培养技术、基质辅助激光解吸/电离飞行时间质谱和耐药性检测在内的一系列方法，对门诊SSTIs患者的伤口拭子进行了分析。在185例SSTIs患者中，179份（96.8%）拭子显示有微生物生长。总共发现了327种微生物，其中285种具有潜在病因学相关性。金黄色葡萄球菌是主要病原体（患病率：71.4%），其次是革兰氏阴性菌阴沟肠杆菌复合体（14.6%）、肺炎克雷伯菌（12.4%）和铜绿假单胞菌（11.8%）。虽然三分之一的金黄色葡萄球菌分离株对大环内酯类、四环素类、复方新诺明和克林霉素耐药，但仅发现一株耐甲氧西林金黄色葡萄球菌（MRSA）菌株。在革兰氏阴性菌中，对氨苄西林和复方新诺明耐药很常见，而超广谱β-内酰胺酶很少被检测到（<1%）。我们得出结论，金黄色葡萄球菌是坦桑尼亚巴加莫约社区获得性SSTIs中最常检测到的病原体。对常用口服抗生素的耐药性相当高，但很少遇到多重耐药菌株。监测SSTIs中的抗生素敏感性模式对于提供定制治疗建议的具体数据很重要。
