School of Nursing, Mae Fah Luang University, Chiang Rai, 57100, Thailand.
School of Health Science, Mae Fah Laung University, Chiang Rai, 57100, Thailand.
BMC Infect Dis. 2021 Apr 26;21(1):385. doi: 10.1186/s12879-021-06087-7.
Antibiotic resistance is often reported and great concerned as one of public health problems especially people living with poverty in developing countries including Thailand. The hill tribe people is defined as vulnerable population for antibiotic resistance in Thailand due to poor economic and education status particularly the Lahu people who is the second greatest group of the hill tribe people in Thailand. The study aimed to estimate the prevalence, factors associated with, and typing major species of bacteria with antibiotic drugs resistance among the Lahu hill tribe people in northern Thailand.
A cross-sectional study was conducted to gather the information from the participants. A validated questionnaire was used for data collection. Participants who presented an illness related to infectious diseases were eligible to participate the study and were asked to obtain specific specimen; sputum, urine or stool. Antibiotic susceptibility was tested by Kirbey Bauer's disc diffusion test. Chi-square and logistic regression were used to detect the associations between variables at the significant level of α = 0.05.
A total of 240 participants were recruited into the study. The majority had urinary tract infection (67.9%) with two major pathogenic species of the infection; Escherichia coli (12.8%), and Enterobacter cloacae (8.0%). The prevalence of antibiotic resistance was 16.0%. Escherichia coli and Klebsiella pneumoniae species were found to have multidrug resistance that was greater than that of other species, while ampicillin was found to have the greatest drug resistance. It was found that those who had poor knowledge of antibiotic use had a 2.56-fold greater chance (95% CI = 1.09-5.32) of having antibiotic resistance than did those who had good knowledge of antibiotic use, and those who had poor antibiotic use behaviors had a 1.79-fold greater chance (95% CI = 1.06-4.80) of having antibiotic resistance than did those who had good antibiotic use behaviors.
Effective public health interventions are urgently needed to reduce antibiotic drug resistance among the Lahu people by improving their knowledge and skills regarding the proper use of antibiotics and eventually minimizing antibiotic resistance. Moreover, health care professionals should strictly follow the standard guideline to prescribe antibiotics.
抗生素耐药性经常被报道，是一个令人关注的公共卫生问题，尤其是在发展中国家，包括泰国，生活贫困的人群中。在泰国，山地部落人群被定义为对抗生素耐药性的脆弱人群，因为他们的经济和教育状况较差，特别是拉祜族，他们是泰国第二大山地部落群体。本研究旨在估计泰国北部拉祜族山地部落人群中细菌对抗生素耐药的流行率、相关因素和主要菌种类型。
采用横断面研究方法收集参与者的信息。使用经过验证的问卷进行数据收集。患有与传染病相关疾病的参与者有资格参加研究，并被要求获得特定的标本；痰、尿或粪便。通过 Kirby-Bauer 圆盘扩散试验检测抗生素敏感性。使用卡方检验和逻辑回归在α=0.05 的显著性水平上检测变量之间的关联。
共有 240 名参与者被纳入研究。大多数参与者患有尿路感染（67.9%），主要有两种感染的主要致病菌种；大肠杆菌（12.8%）和阴沟肠杆菌（8.0%）。抗生素耐药率为 16.0%。发现大肠杆菌和肺炎克雷伯菌具有大于其他菌种的多药耐药性，而氨苄西林的耐药性最大。研究发现，对抗生素使用知识较差的人发生抗生素耐药的几率是对抗生素使用知识良好的人的 2.56 倍（95%CI=1.09-5.32），而抗生素使用行为较差的人发生抗生素耐药的几率是良好的人的 1.79 倍（95%CI=1.06-4.80）。
迫切需要采取有效的公共卫生干预措施，通过提高拉祜族人群对抗生素合理使用的知识和技能，减少抗生素耐药性，并最终最大限度地减少抗生素耐药性。此外，医疗保健专业人员应严格遵循标准指南来开具抗生素。
