Han Khin Sl, Gustavo Lopez, Rajkumar Venesh C, Swe Swe-Han Khine
Intensive care unit, Stanger Hospital, Stanger, South Africa.
Ilembe Health District, Stanger Hospital, Kwa-Dukuza, Stanger, South Africa.
J Infect Dev Ctries. 2019 Aug 31;13(8):748-752. doi: 10.3855/jidc.10685.
Antimicrobial stewardship practices are crucial for the regular surveillance to change the antimicrobial policy. This study was conducted to decide the prevalence of common bacteria and their antibiogram regarding antimicrobial stewardship program within one year, at the regional and district, Stanger hospital in South Africa.
It was based the study on clinical data and laboratory records of the patients. It reviewed the clinical and laboratory data. The prevalence/proportion rate was calculated and correlated with the majority of microorganism vs empirical therapy.
The prevalence of MRSA, MRSE, VRSA, ESBL+ K. pneumoniae; E. coli cultured from the blood was 25%, 49%, 2%, 62% and 27% respectively. Similarly, we analysed for other targeted MDROs organisms (Acinetobacter species and P. aeruginosa, CRE, CPE) isolated from blood culture and endotracheal aspirate. The prevalence of MDR Acinetobacter species exceeded 61%, 33% from the blood and ETA respectively. The prevalence of MDR P. aeruginosa was 10% from ETA. The MRSA, MRSE, VRSA, VRE were observed in blood specimen. The majority of the microorganisms cultured from the CSF was Cryptococcus neoformans and followed by bacteria: Streptococcus pneumonia, Streptococcus group B and Haemorphilus influenza.
The selection of empirical antimicrobial therapy relates not only the institutions or unit-specific antibiogram but also the site of infection. We can further suggest continuing to do surveillance of antibiogram and prevalence of MDR organisms for infection control as well as for empirical therapy, part of the antimicrobial stewardship program based on yearly records to change the local hospital antibiotic policy.
抗菌药物管理措施对于定期监测以改变抗菌药物政策至关重要。本研究旨在确定南非斯特兰杰地区医院在一年内关于抗菌药物管理计划的常见细菌流行率及其抗菌谱。
该研究基于患者的临床数据和实验室记录。回顾了临床和实验室数据。计算了流行率/比例率，并将其与大多数微生物与经验性治疗进行了关联。
从血液中培养出的耐甲氧西林金黄色葡萄球菌（MRSA）、耐甲氧西林表皮葡萄球菌（MRSE）、耐万古霉素金黄色葡萄球菌（VRSA）、产超广谱β-内酰胺酶肺炎克雷伯菌（ESBL+ K. pneumoniae）和大肠杆菌的流行率分别为25%、49%、2%、62%和27%。同样，我们分析了从血培养和气管内吸出物中分离出的其他目标多重耐药菌（不动杆菌属、铜绿假单胞菌、耐碳青霉烯类肠杆菌科细菌、耐碳青霉烯类肺炎克雷伯菌）。多重耐药不动杆菌属的流行率在血液和气管内吸出物中分别超过61%和33%。气管内吸出物中多重耐药铜绿假单胞菌的流行率为10%。在血液标本中观察到了MRSA、MRSE、VRSA和耐万古霉素肠球菌（VRE）。从脑脊液中培养出的大多数微生物是新型隐球菌，其次是细菌：肺炎链球菌、B组链球菌和流感嗜血杆菌。
经验性抗菌治疗的选择不仅与机构或单位特定的抗菌谱有关，还与感染部位有关。我们可以进一步建议继续对抗菌谱和多重耐药菌的流行率进行监测，以进行感染控制以及经验性治疗，这是基于年度记录的抗菌药物管理计划的一部分，以改变当地医院的抗生素政策。
