肯尼亚卡普萨贝特县转诊医院腹泻儿童分离的空肠弯曲菌和志贺菌的多重耐药性。
Multiple drug resistance of Campylobacter jejuni and Shigella isolated from diarrhoeic children at Kapsabet County referral hospital, Kenya.
机构信息
Department of Health Services, University of Eldoret, P.O. Box 1125, Eldoret, 30100, Kenya.
Department of Biological Sciences, University of Eldoret, P.O. Box 1125, Eldoret, 30100, Kenya.
出版信息
BMC Infect Dis. 2021 Jan 23;21(1):109. doi: 10.1186/s12879-021-05788-3.
BACKGROUND
Diarrhoea is a common cause of mortality and morbidity in children under five years old. In Kenya, it has a 21% case fatality with Enteropathogenic E. coli, Campylobacter jejuni, Shigella spp. and Salmonella spp. accounting for 50-60% of the cases. Sulphonamides, tetracycline, ampicillin and trimethoprim/sulfamethoxazole are typically used in the treatment of diarrhoeal diseases but have become ineffective in the face of emerging antimicrobial resistance. The objective of this study was to evaluate the prevalence and antimicrobial susceptibility of Campylobacter jejuni and Shigella species in children under five years of age presenting with diarrhoea at Kapsabet County Referral Hospital in Kenya.
METHODS
Faecal samples were collected from 139 children admitted with diarrhoea. Each sample was examined macroscopically for colour, texture, and presence of extraneous material. The samples were then cultured for bacterial growth. Observed bacterial growth was isolated and identified by a series of biochemical tests. Resistance patterns were also evaluated using the Kirby - Bauer Disk diffusion method. The chi - square test and Pearson Correlation Coefficient were used to establish statistical significance.
RESULTS
Approximately 33.1% of the total faecal samples tested were positive for enteric pathogens. Shigella spp. demonstrated resistance to erythromycin (91.7%), doxycyclin (83.3%), ampicillin (82.1%), cotrimoxazole (73.1%), minocycline (66.7%) and cefuroxime (54.2%). Campylobacter jejuni also exhibited resistance to erythromycin (87.5%), doxycyclin (75%), ampicillin (73.7%), cotrimoxazole (73.3%) and minocycline (68.8%).
CONCLUSIONS
The resistance patterns of Shigella spp. and Campylobacter jejuni reported in this study necessitates the need for a comprehensive multiregional investigation to evaluate the geographical prevalence and antimicrobial resistance distributions of these microorganisms. These findings also support the need for the discovery and development of effective therapeutic alternatives.
TRIAL REGISTRATION
Retrospectively registered. Certificate No. 00762.
背景
腹泻是五岁以下儿童死亡和发病的常见原因。在肯尼亚，肠致病性大肠杆菌、空肠弯曲菌、志贺氏菌和沙门氏菌导致的腹泻病例病死率为 21%，占病例的 50-60%。磺胺类药物、四环素、氨苄西林和甲氧苄啶/磺胺甲噁唑通常用于治疗腹泻病，但面对新出现的抗菌素耐药性已变得无效。本研究的目的是评估肯尼亚卡普萨贝特县转诊医院五岁以下腹泻患儿中空肠弯曲菌和志贺氏菌的流行情况和抗菌素敏感性。
方法
从 139 名因腹泻住院的儿童中采集粪便样本。每个样本均进行外观检查，包括颜色、质地和有无异物。然后将样本进行细菌培养。观察到的细菌生长通过一系列生化试验进行分离和鉴定。采用 Kirby-Bauer 纸片扩散法评估耐药模式。使用卡方检验和 Pearson 相关系数确定统计学意义。
结果
约 33.1%的粪便样本检测呈肠病原体阳性。志贺氏菌对红霉素（91.7%）、强力霉素（83.3%）、氨苄西林（82.1%）、复方新诺明（73.1%）、米诺环素（66.7%）和头孢呋辛（54.2%）耐药。空肠弯曲菌也对红霉素（87.5%）、强力霉素（75%）、氨苄西林（73.7%）、复方新诺明（73.3%）和米诺环素（68.8%）耐药。
结论
本研究报道的志贺氏菌和空肠弯曲菌的耐药模式需要进行全面的多区域调查，以评估这些微生物的地理流行程度和抗菌素耐药分布。这些发现还支持需要发现和开发有效的治疗替代品。
试验注册
回顾性注册。注册号 00762。
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