埃塞俄比亚疑似肺炎链球菌感染患者分离株的抗菌药物耐药谱及多药耐药模式。
Antimicrobial resistance profile and multidrug resistance patterns of Streptococcus pneumoniae isolates from patients suspected of pneumococcal infections in Ethiopia.
机构信息
Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, P. O. Box 45, Dessie, Ethiopia.
出版信息
Ann Clin Microbiol Antimicrob. 2021 Apr 20;20(1):26. doi: 10.1186/s12941-021-00432-z.
BACKGROUND
Antimicrobial-resistant strains of Streptococcus pneumoniae have become one of the greatest challenges to global public health today and inappropriate use of antibiotics and high level of antibiotic use is probably the main factor driving the emergence of resistance worldwide. The aim of this study is, therefore, to assess the antimicrobial resistance profiles and multidrug resistance patterns of S. pneumoniae isolates from patients suspected of pneumococcal infections in Ethiopia.
METHODS
A hospital-based prospective study was conducted from January 2018 to December 2019 at Addis Ababa city and Amhara National Region State Referral Hospitals. Antimicrobial resistance tests were performed from isolates of S. pneumoniae that were collected from pediatric and adult patients. Samples (cerebrospinal fluid, blood, sputum, eye discharge, ear discharge, and pleural and peritoneal fluids) from all collection sites were initially cultured on 5% sheep blood agar plates and incubated overnight at 37 °C in a 5% CO atmosphere. Streptococcus pneumoniae was identified and confirmed by typical colony morphology, alpha-hemolysis, Gram staining, optochin susceptibility, and bile solubility test. Drug resistance testing was performed using the E-test method according to recommendations of the Clinical and Laboratory Standards Institute.
RESULTS
Of the 57 isolates, 17.5% were fully resistant to penicillin. The corresponding value for both cefotaxime and ceftriaxone was 1.8%. Resistance rates to erythromycin, clindamycin, tetracycline, chloramphenicol and trimethoprim-sulfamethoxazole were 59.6%, 17.5%, 38.6%, 17.5 and 24.6%, respectively. Multidrug resistance (MDR) was seen in 33.3% isolates. The most common pattern was co-resistance to penicillin, erythromycin, clindamycin, and tetracycline.
CONCLUSIONS
Most S. pneumoniae isolates were susceptible to ceftriaxone and cefotaxime. Penicillin has been used as a drug of choice for treating S. pneumoniae infection. However, antimicrobial resistance including multidrug resistance was observed to several commonly used antibiotics including penicillin. Hence, it is important to periodically monitor the antimicrobial resistance patterns to select empirical treatments for better management of pneumococcal infection.
背景
肺炎链球菌的耐药菌株已成为当今全球公共卫生的最大挑战之一，而抗生素的不恰当使用和高使用水平可能是全球耐药性出现的主要因素。因此，本研究旨在评估埃塞俄比亚疑似肺炎链球菌感染患者分离株的抗菌药物耐药谱和多药耐药模式。
方法
这是一项 2018 年 1 月至 2019 年 12 月在亚的斯亚贝巴市和阿姆哈拉州立转诊医院进行的基于医院的前瞻性研究。从儿科和成年患者分离的肺炎链球菌分离株进行抗菌药物耐药性检测。所有采集部位的样本（脑脊液、血液、痰液、眼分泌物、耳分泌物以及胸腔和腹腔液）最初均在 5%绵羊血琼脂平板上培养，并在 37°C、5%CO 环境中孵育过夜。通过典型的菌落形态、α-溶血、革兰氏染色、奥普西林敏感性和胆汁溶解度试验鉴定和确认肺炎链球菌。根据临床和实验室标准协会的建议，使用 E 试验法进行药物敏感性试验。
结果
在 57 株分离株中，有 17.5%对青霉素完全耐药。头孢噻肟和头孢曲松的相应值分别为 1.8%。红霉素、克林霉素、四环素、氯霉素和磺胺甲恶唑的耐药率分别为 59.6%、17.5%、38.6%、17.5%和 24.6%。33.3%的分离株表现出多药耐药性。最常见的模式是对青霉素、红霉素、克林霉素和四环素的共同耐药。
结论
大多数肺炎链球菌分离株对头孢曲松和头孢噻肟敏感。青霉素一直被用作治疗肺炎链球菌感染的首选药物。然而，包括青霉素在内的几种常用抗生素都出现了抗菌药物耐药性，包括多药耐药性。因此，定期监测抗菌药物耐药模式对于选择经验性治疗以更好地管理肺炎链球菌感染非常重要。
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