Adesanya Oluwafolajimi Adetoye, Igwe Hilda Amauche
Institute for Advanced Medical Research and Training (IAMRAT), College of Medicine, University of Ibadan, Ibadan, Nigeria.
Department of Clinical Microbiology and Parasitology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
AIMS Public Health. 2020 Oct 16;7(4):804-815. doi: 10.3934/publichealth.2020062. eCollection 2020.
Carbapenem-resistant (CRE) are often responsible for severe, life-threatening infections and they represent a critical threat to the available antibiotic agents and to global health. An understanding of the epidemiology of these infections will be indispensable to the development of appropriate case management as well as infection prevention and control (IPC) measures in any healthcare setting.
The objective of this study was to investigate and describe the epidemiology of carbapenem-resistant (CRE) and other gram-negative bacteria in a tertiary hospital in south west Nigeria using routinely collected microbiological laboratory data.
A retrospective collection of microbiological laboratory records from the January to June 2018 was performed. All culture and antimicrobial susceptibility test results of patients who required laboratory tests were collected. Other information collected include: patient demographics, clinical specimen types and the requesting hospital department. The data was analyzed using SPSS Windows version 24. Comparison between categorical variables was done using chi-square tests while independent sample t-test was used to determine significant mean differences between groups. A < 0.05 was taken to be statistically significant.
The prevalence of carbapenem-resistance among and gram-negative bacteria isolates was 22% (n = 39/177). Of these, 35.9% (n = 14) were , 30.8% (n = 12) were and 15.4% (n = 6) were . 87.2% (n = 34) of these were also multi-drug resistant, with a mean total resistance score of 3.92 (SD = ± 1.44). There were differences observed in proportion of carbapenem-resistance across clinical specialties and age groups; however, these differences were not statistically significant. Independent sample t-test revealed that carbapenem-resistant isolates exhibited more drug resistance than carbapenem-sensitive isolates (3.93 vs. 2.30; < 0.001).
Carbapenem resistance is an important threat to the current antibiotic armory. Active surveillance, particularly in the healthcare setting is required to identify high risk groups, inform better treatment options and infection prevention and control measures.
耐碳青霉烯类肠杆菌科细菌（CRE）常引发严重的、危及生命的感染，对现有抗生素药物及全球健康构成重大威胁。了解这些感染的流行病学情况对于在任何医疗机构制定适当的病例管理以及感染预防与控制（IPC）措施都至关重要。
本研究的目的是利用常规收集的微生物实验室数据，调查并描述尼日利亚西南部一家三级医院中耐碳青霉烯类肠杆菌科细菌（CRE）及其他革兰氏阴性菌的流行病学情况。
对2018年1月至6月的微生物实验室记录进行回顾性收集。收集了所有需要实验室检测的患者的培养及抗菌药敏试验结果。收集的其他信息包括：患者人口统计学资料、临床标本类型及送检医院科室。使用SPSS Windows 24版对数据进行分析。分类变量之间的比较采用卡方检验，而独立样本t检验用于确定组间显著的均值差异。P < 0.05被认为具有统计学意义。
在肠杆菌科细菌和革兰氏阴性菌分离株中，耐碳青霉烯类的患病率为22%（n = 39/177）。其中，35.9%（n = 14）为肺炎克雷伯菌，30.8%（n = 12）为大肠埃希菌，15.4%（n = 6）为阴沟肠杆菌。其中87.2%（n = 34）也具有多重耐药性，平均总耐药评分为3.92（标准差 = ± 1.44）。在不同临床专科和年龄组中，耐碳青霉烯类的比例存在差异；然而，这些差异无统计学意义。独立样本t检验显示，耐碳青霉烯类分离株比碳青霉烯类敏感分离株表现出更多的耐药性（3.93对2.30；P < 0.001）。
耐碳青霉烯类对当前的抗生素储备构成重要威胁。需要进行主动监测，尤其是在医疗机构中，以识别高危人群，为更好的治疗选择及感染预防与控制措施提供依据。
