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埃塞俄比亚西北部贡德尔大学转诊医院中无乳链球菌的新生儿定植和抗生素药敏模式。

Newborn colonization and antibiotic susceptibility patterns of Streptococcus agalactiae at the University of Gondar Referral Hospital, Northwest Ethiopia.

机构信息

Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.

Department of Gynecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.

出版信息

BMC Pediatr. 2018 Nov 30;18(1):378. doi: 10.1186/s12887-018-1350-1.

Abstract

BACKGROUND

Group B Streptococcus (GBS) that asymptomatically colonizing the recto-vaginal area of women is the most important cause of neonatal colonization. There is paucity of evidence about newborn colonization with GBS in Ethiopia. Thus, this study was aimed to determine the prevalence of newborn colonization with GBS, antibiotic susceptibility patterns of the isolates and associated risk factors at the University of Gondar Referral Hospital in Northwest Ethiopia METHODS: A prospective cross sectional study was conducted from December 2016 to November 2017. A total of 1,155 swabs from nasal, ear and umbilical areas of the newborns were collected from the 385 newborns. Identifications of the isolates and antibiotic susceptibility testing were done by using conventional methods.

RESULTS

Sixty two (16.1%, 95% CI: 12.2% - 20%) of the newborns were colonized by GBS. Seven percent of the total specimens were positive for GBS. The antibiotics susceptibility rates of GBS (average of the three body sites tested) were 95.1%, 89.6%, 88.9%, 85.7%, 85.3%, 81.3%, 76.9%, 76.1%, 73.8%, and 34.4% to ampicillin, penicillin, ciprofloxacin, chloramphenicol, vancomycin, azitromycin, erythromycin, clindamycin, ceftriaxone, and tetracycline, respectively. A multilogistic regression analyses were shown that the newborns that were from mothers whose education status was below tertiary level, and newborns from mothers who were: being employed, being nullipara and multigravida were at risk for colonization with GBS.

CONCLUSION

Prevalence of neonatal colonization with GBS was higher than it was reported in three decades ago in Ethiopia. Ciprofloxacin, chloramphenicol, vancomycin and azithromycin were identified as the drug of choice next to ampicillin and penicillin.

摘要

背景

无症状定植于女性直肠-阴道区域的 B 群链球菌(GBS)是导致新生儿定植的最重要原因。关于埃塞俄比亚新生儿 GBS 定植的证据很少。因此,本研究旨在确定埃塞俄比亚贡德尔大学教学医院新生儿 GBS 定植的流行率、分离株的抗生素药敏模式以及相关危险因素。

方法

本前瞻性横断面研究于 2016 年 12 月至 2017 年 11 月进行。共从 385 名新生儿的鼻腔、耳朵和脐部采集 1155 个拭子。采用常规方法进行分离株鉴定和抗生素药敏试验。

结果

62 名(16.1%,95%CI:12.2%-20%)新生儿被 GBS 定植。总的来说,有 7%的标本 GBS 阳性。GBS(测试的三个身体部位的平均值)对氨苄西林、青霉素、环丙沙星、氯霉素、万古霉素、阿奇霉素、红霉素、克林霉素、头孢曲松和四环素的抗生素药敏率分别为 95.1%、89.6%、88.9%、85.7%、85.3%、81.3%、76.9%、76.1%、73.8%和 34.4%。多因素逻辑回归分析显示,母亲受教育程度低于大专、职业、初产妇和多产妇的新生儿有 GBS 定植的风险。

结论

与三十年前在埃塞俄比亚的报告相比,新生儿 GBS 定植的流行率更高。环丙沙星、氯霉素、万古霉素和阿奇霉素与氨苄西林和青霉素一起被确定为首选药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c11/6271408/a6e11ecab300/12887_2018_1350_Fig1_HTML.jpg

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