从吉姆马大学医学中心与医疗保健相关感染患者中分离出高耐药细菌：一项横断面研究。
Emergence of high drug resistant bacterial isolates from patients with health care associated infections at Jimma University medical center: a cross sectional study.
机构信息
1School of Medical Laboratory Science, Jimma University, Jimma, Ethiopia.
11Institute of Health, Jimma University, P.O. Box 1368, Jimma, Ethiopia.
出版信息
Antimicrob Resist Infect Control. 2018 Nov 19;7:138. doi: 10.1186/s13756-018-0431-0. eCollection 2018.
BACKGROUND
The rates of resistant microorganisms which complicate the management of healthcare associated infections (HAIs) are increasing worldwide and getting more serious in developing countries. The objective of this study was to describe microbiological features and resistance profiles of bacterial pathogens of HAIs in Jimma University Medical Center (JUMC) in Ethiopia.
METHODS
Institution based cross sectional study was carried out on hospitalized patients from May to September, 2016 in JUMC. Different clinical specimens were collected from patients who were suspected to hospital acquired infections. The specimens were processed to identify bacterial etiologies following standard microbiological methods. Antibacterial susceptibility was determined in vitro by Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines.
RESULTS
Overall, 126 bacterial etiologies were isolated from 118 patients who had HAIs. Of these, 100 (79.4%) were gram negative and the remaining were gram positive. The most common isolates were 31(24.6%), species 30(23.8%) and 26 (20.6%). Of 126 bacterial isolates, 38 (30.2%), 52 (41.3%), and 24 (19%) were multidrug-resistant (MDR, resistant to at least one agent in three or more antimicrobial categories), extensively drug resistant (XDR, resistant to at least one agent in all but two or fewer antimicrobial categories (i.e. bacterial isolates remain susceptible to only one or two categories), pan-drug resistant (PDR, resistant to all antibiotic classes) respectively. More than half of isolated gram-negative rods (51%) were positive for extended spectrum beta-lactamase (ESBL) and/or AmpC; and 25% of gram negative isolates were also resistant to carbapenem antibiotics.
CONCLUSIONS
The pattern of drug resistant bacteria in patients with healthcare associated infection at JUMC is alarming. This calls for coordinated efforts from all stakeholders to prevent HAIs and drug resistance in the study setting.
背景
全球范围内，导致医疗保健相关性感染（HAI）治疗复杂化的耐药微生物的发生率正在上升，在发展中国家情况更为严重。本研究旨在描述埃塞俄比亚 Jimma 大学医学中心（JUMC）HAI 细菌病原体的微生物学特征和耐药谱。
方法
这是一项 2016 年 5 月至 9 月在 JUMC 住院患者中进行的基于机构的横断面研究。从疑似医院获得性感染的患者中采集了不同的临床标本。根据标准微生物学方法对标本进行处理以鉴定细菌病因。按照临床和实验室标准协会指南，通过 Kirby-Bauer 纸片扩散法在体外测定抗菌药物敏感性。
结果
总体而言，从 118 例发生 HAI 的患者中分离出 126 株细菌病原体。其中，100 株（79.4%）为革兰氏阴性菌，其余为革兰氏阳性菌。最常见的分离株是 31 株（24.6%）、 种 30 株（23.8%）和 26 株（20.6%）。在 126 株细菌分离株中，38 株（30.2%）、52 株（41.3%）和 24 株（19%）为多重耐药（MDR，对至少三种抗菌药物类别的一种药物耐药）、广泛耐药（XDR，对除两种或更少抗菌药物类别以外的所有药物耐药（即细菌分离株仅对一种或两种类别敏感）、全耐药（PDR，对所有抗生素类别耐药）。超过一半的革兰氏阴性杆菌（51%）产超广谱β-内酰胺酶（ESBL）和/或 AmpC；25%的革兰氏阴性菌也对碳青霉烯类抗生素耐药。
结论
JUMC 发生 HAI 的患者中耐药菌的流行模式令人震惊。这需要所有利益相关者共同努力，以防止研究环境中的 HAI 和耐药性。
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