Department of Emergency Medicine, Alpert Medical School, Brown University, 55 Claverick Street, Providence, RI, 02903, USA.
Department of Biostatistics, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA.
Int J Infect Dis. 2021 Apr;105:436-441. doi: 10.1016/j.ijid.2021.02.102. Epub 2021 Feb 26.
Few studies have evaluated determinants of multidrug-resistant (MDR) Vibrio cholerae O1 in older children and adults. This study aimed to characterize the prevalence of MDR V. cholerae O1 and associated risk factors among patients over five years of age in Bangladesh.
Stool culture and antimicrobial susceptibility testing were performed as a part of a larger study at Dhaka Hospital in Bangladesh from March 2019-March 2020. Univariate statistics and multiple logistic regression were used to assess the association between a range of variables and MDR V. cholerae O1.
MDR was found in 175 of 623 (28.1%) V. cholerae O1 isolates. High levels of resistance were found to erythromycin (99.2%), trimethoprim-sulfamethoxazole (99.7%), and ampicillin (88.9%), while susceptibility was high to tetracyclines (99.7%), azithromycin (99.2%), ciprofloxacin (99.8%), and cephalosporins (98.6%). MDR was associated with prior antibiotic use, longer transport time to hospital, higher income, non-flush toilet use, greater stool frequency, lower blood pressure, lower mid-upper arm circumference, and lower percent dehydration.
MDR V. cholerae O1 was common among patients over five in an urban hospital in Bangladesh. Significant factors associated with MDR may be actionable in identifying patients with a high likelihood of MDR.
鲜有研究评估多重耐药（MDR）霍乱弧菌 O1 在较大儿童和成人中的决定因素。本研究旨在描述孟加拉国 5 岁以上患者中 MDR 霍乱弧菌 O1 的流行情况及其相关危险因素。
在孟加拉国达卡医院进行的一项更大规模的研究中，于 2019 年 3 月至 2020 年 3 月进行了粪便培养和抗菌药物敏感性试验。采用单变量统计和多因素逻辑回归评估了一系列变量与 MDR 霍乱弧菌 O1 之间的关联。
在 623 株霍乱弧菌 O1 分离株中，发现 175 株（28.1%）为 MDR。对红霉素（99.2%）、甲氧苄啶-磺胺甲恶唑（99.7%）和氨苄西林（88.9%）的耐药水平较高，而对四环素（99.7%）、阿奇霉素（99.2%）、环丙沙星（99.8%）和头孢菌素（98.6%）的敏感性较高。MDR 与既往抗生素使用、更长的运输时间到医院、更高的收入、非冲水厕所使用、更高的粪便频率、更低的血压、更低的中上臂围和更低的脱水百分比有关。
在孟加拉国一家城市医院，5 岁以上患者中 MDR 霍乱弧菌 O1 很常见。与 MDR 相关的重要因素可能有助于确定 MDR 可能性高的患者。
