Pokharel Khilasa, Dawadi Bishwa Raj, Bhatt Chandra Prakash, Gupte Satish, Jha Beena
Department of Microbiology, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal.
Department of Emergency Medicine, Grande International Hospital, Dhapasi, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2018 Nov-Dec;56(214):931-935. doi: 10.31729/jnma.4006.
Gram negative bacilli are the important causes of common clinical infections. Carbapenem resistant Enterobacteriaceae are considered as important public health threat and is classified as urgent by the Centers of Disease Control and Prevention because of their progressive geographic dissemination and limited therapeutic alternatives. This study was done to find out the resistance pattern of Carbapenem among Enterobacteriaceae.
The descriptive cross-sectional study was carried out in Clinical Microbiology laboratory from February 2018 to May 2018 after ethical approval. Organism was identified on the basis of its microscopic observation by performing Gram's stain and by identification of morphology after its growth in culture media followed by its biochemical reactions. Antibiotic sensitivity test of isolated pathogens was done using Muller Hinton Agar by the standard disk diffusion technique of Kirby-Bauer method.
In our study, total 1055 sample belongs to the family Enterobacteriaceae. From the family Enterobactericeae, 348 (27%) of the bacilli were found to be Carbapenem resistant. Among which most common bacteria was Klebsiella pneumoniae followed by Escherichia coli. All strains of Carbapenem resistant Enterobacteriaceae were sensitive to Colistin, Polymyxin B and Tigecycline.
Among Enterobacteriaceae, around one-third of the bacterial isolates were Carbapenem resistant. However, to reduce drug resistance antimicrobial stewardship programme and proper infection control measures is required.
革兰氏阴性杆菌是常见临床感染的重要病因。耐碳青霉烯类肠杆菌科细菌被视为重要的公共卫生威胁,由于其在地理上的不断传播以及治疗选择有限,被美国疾病控制与预防中心列为紧急情况。本研究旨在了解肠杆菌科细菌对碳青霉烯类药物的耐药模式。
在获得伦理批准后,于2018年2月至2018年5月在临床微生物实验室开展了描述性横断面研究。通过革兰氏染色进行显微镜观察,并在培养基中培养后根据形态学及生化反应鉴定微生物。采用Kirby-Bauer法的标准纸片扩散技术,使用Muller Hinton琼脂对分离出的病原体进行药敏试验。
在我们的研究中,共有1055份样本属于肠杆菌科。在肠杆菌科中,发现348株(27%)杆菌对碳青霉烯类耐药。其中最常见的细菌是肺炎克雷伯菌,其次是大肠杆菌。所有耐碳青霉烯类肠杆菌科细菌菌株对黏菌素、多黏菌素B和替加环素敏感。
在肠杆菌科中,约三分之一的细菌分离株对碳青霉烯类耐药。然而,为了降低耐药性,需要实施抗菌药物管理计划并采取适当的感染控制措施。