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埃塞俄比亚西南部吉马镇耳部流脓患者分离出细菌的抗菌药敏模式。

Antimicrobial susceptibility patterns of bacteria isolated from patients with ear discharge in Jimma Town, Southwest, Ethiopia.

作者信息

Gorems Kasahun, Beyene Getenet, Berhane Melkamu, Mekonnen Zeleke

机构信息

1School of Medical Laboratory Sciences, Institute of Health, Jimma University, P.O. Box 378, Jimma, Ethiopia.

2Department of Pediatrics and Child Health, Institute of Health, Jimma University, Jimma, Ethiopia.

出版信息

BMC Ear Nose Throat Disord. 2018 Dec 4;18:17. doi: 10.1186/s12901-018-0065-0. eCollection 2018.

Abstract

BACKGROUND

Otitis media is among the leading causes of childhood illnesses although it can also affect the adults resulting in frequent physician visits, drug prescription and a key contributor to antibiotic resistance. The aim of this study was to determine the risk factors, bacterial profile, and the antimicrobial susceptibility pattern of the isolates from patients with discharging ears which clinically equates to draining otitis media in developing countries with limited medical resources such as otoscope.

METHODS

A prospective cross-sectional study was conducted on 173 patients with draining otitis media. The ear discharge specimens were collected and analyzed by standard microbial techniques. The antibiotic susceptibility profiles were determined for 19 different antibiotics by the standard disk diffusion method. Data was analyzed by SPSS version 22 and the value of less than 0.05 was considered as statistically significant.

RESULTS

Among 173 otitis media patients participated in the study; majority, 102(63%) were pediatrics, out of which 72 (41.61%) were in the age group of less than 4 years. Ear infection was bilateral in 39 (22.54%) and chronic in 100 (57.8%) of the patients. Pathogens were isolated from 160 (92.5%) of the patients with a total of 179 isolates. The predominant isolate was (30.72%) followed by spp. (17.89%). The result of this study showed that adult age ( = 0.031), rural residence ( = 0.005), previous history of health care visit and treatment ( = 0.000), upper respiratory tract infection ( = 0.018) and presence of cigarette smoker in the house ( = 0.022) had statistically significant association with chronic otitis media. Most of the isolated bacteria showed high level of resistance to ampicillin/amoxicillin (88.3%), penicillin G (79.5%) followed by trimethoprim /sulfamethoxazole (73.8%). Conversely, the majority of bacterial isolates showed moderate susceptibility to ciprofloxacin (72.9%), gentamicin (70.4%), and amikacin (69.3%). Bacterial isolates identified in this study showed trend of multiple drug resistance, majority (67%) being resistant to three or more antimicrobials.

CONCLUSIONS

Majority of the bacterial isolates were multidrug resistant, hence, efforts to isolate microorganisms and determine the susceptibility pattern should be strengthened to improve the treatment outcome of otitis media instead of the usual trend of empirical treatment.

摘要

背景

中耳炎是儿童疾病的主要病因之一,不过它也会影响成年人,导致患者频繁就医、药物处方开具,并且是抗生素耐药性的一个关键促成因素。本研究的目的是确定来自耳流脓患者分离株的危险因素、细菌谱以及抗菌药物敏感性模式,在医疗资源有限(如耳镜)的发展中国家,临床上这种情况等同于渗出性中耳炎。

方法

对173例渗出性中耳炎患者进行了一项前瞻性横断面研究。收集耳分泌物标本并通过标准微生物技术进行分析。采用标准纸片扩散法测定19种不同抗生素的药敏谱。数据用SPSS 22版进行分析,P值小于0.05被认为具有统计学意义。

结果

参与研究的173例中耳炎患者中,大多数(102例,63%)是儿童,其中72例(41.61%)年龄小于4岁。39例(22.54%)患者耳部感染为双侧性,100例(57.8%)为慢性感染。从160例(92.5%)患者中分离出病原体,共179株。主要分离株是[具体菌株未给出](30.72%),其次是[具体菌株未给出]属(17.89%)。本研究结果表明,成年人年龄(P = 0.031)、农村居住(P = 0.005)、既往就医和治疗史(P = 0.000)、上呼吸道感染(P = 0.018)以及家中有吸烟者(P = 0.022)与慢性中耳炎有统计学显著关联。大多数分离出的细菌对氨苄西林/阿莫西林(88.3%)、青霉素G(79.5%)耐药性较高,其次是甲氧苄啶/磺胺甲恶唑(73.8%)。相反,大多数细菌分离株对环丙沙星(72.9%)、庆大霉素(70.4%)和阿米卡星(69.3%)表现出中度敏感性。本研究中鉴定出的细菌分离株呈现多重耐药趋势,大多数(67%)对三种或更多抗菌药物耐药。

结论

大多数细菌分离株具有多重耐药性,因此,应加强分离微生物并确定药敏模式的工作,以改善中耳炎的治疗效果,而不是通常的经验性治疗趋势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d87/6278048/00d8a81e3c6b/12901_2018_65_Fig1_HTML.jpg

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