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评估从伊朗德黑兰莫菲德儿童医院患者的临床标本中分离出的主要细菌病原体的抗菌耐药模式:2013 - 2018年。

Evaluating the antimicrobial resistance patterns among major bacterial pathogens isolated from clinical specimens taken from patients in Mofid Children's Hospital, Tehran, Iran: 2013-2018.

作者信息

Azimi Taher, Maham Saied, Fallah Fatemeh, Azimi Leila, Gholinejad Zari

机构信息

Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Infect Drug Resist. 2019 Jul 17;12:2089-2102. doi: 10.2147/IDR.S215329. eCollection 2019.

Abstract

BACKGROUND

This study evaluates the epidemiology and antimicrobial resistance profile of Gram-negative bacteria (GNB) and Gram-positive bacteria (GPB) isolated from clinical specimens in children admitted to Mofid Children's Hospital.

METHODS

This was a retrospective study of the patients' clinical specimens collected from January 2013 until the end of December 2018. All specimens were evaluated to determine the presence of infection-causing agents using a BACTEC 9120 blood culture. Isolation and identification of bacterial strains were performed using conventional biochemical tests. Antibiotic resistance was determined using Kirby-Bauer disk diffusion and broth microdilution methods. Results were interpreted according to CLSI and EUCAST.

RESULTS

A total of 1130 different pathogenic bacteria were detected from 14,690 different clinical specimens and the overall detection rate was 7.7% (1130/14,690). Among bacterial pathogen isolated from clinical specimens, 55% (n=622) were GNB and 45% (n=508) were GPB. The predominant GNB isolates were spp., spp., spp., respectively. Among GPB, CoNS was the most frequent and spp. was found to have low levels of resistance to linezolid. In GNB, most and were ceftriaxone resistant. was found to have low levels of resistance to levofloxacin and ciprofloxacin.

CONCLUSIONS

Our findings revealed that the resistance rate among GNB and GPB associated with different infections in children is very high. These results suggest a constant screening and follow-up programs for the detection of antibiotic resistance, and it also suggests to develop antimicrobial stewardship programs in Tehran, Iran.

摘要

背景

本研究评估了从莫菲德儿童医院收治的儿童临床标本中分离出的革兰氏阴性菌(GNB)和革兰氏阳性菌(GPB)的流行病学及抗菌药物耐药情况。

方法

这是一项对2013年1月至2018年12月底收集的患者临床标本的回顾性研究。所有标本均使用BACTEC 9120血培养仪进行评估,以确定是否存在感染病原体。采用传统生化试验进行细菌菌株的分离和鉴定。使用 Kirby-Bauer 纸片扩散法和肉汤微量稀释法测定抗生素耐药性。结果根据CLSI和EUCAST进行解释。

结果

从14690份不同临床标本中总共检测出1130种不同的病原菌,总体检出率为7.7%(1130/14690)。在从临床标本中分离出的细菌病原体中,55%(n = 622)为GNB,45%(n = 508)为GPB。主要的GNB分离株分别为 菌属、 菌属、 菌属。在GPB中,凝固酶阴性葡萄球菌最为常见,并发现 菌属对利奈唑胺耐药水平较低。在GNB中,大多数 和 对头孢曲松耐药。发现 对左氧氟沙星和环丙沙星耐药水平较低。

结论

我们的研究结果显示,与儿童不同感染相关的GNB和GPB耐药率非常高。这些结果表明需要持续开展筛查和随访计划以检测抗生素耐药性,同时也建议在伊朗德黑兰制定抗菌药物管理计划。

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