Yitayeh Litegebew, Gize Addisu, Kassa Melkayehu, Neway Misrak, Afework Aschalew, Kibret Mulugeta, Mulu Wondemagegn
GAMBY Teaching General Hospital, Bahir Dar, Ethiopia.
Department of Microbiology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Infect Drug Resist. 2021 Jun 15;14:2225-2232. doi: 10.2147/IDR.S307267. eCollection 2021.
Infections with multi-drug resistant (MDR) bacteria are serious threats to many low-income countries associated with overuse and misuse of antibiotics. This study determined the antibiogram profiles of bacteria isolated from different body site infections among patients admitted to GAMBY Teaching General Hospital, Bahir Dar, Northwest Ethiopia.
A hospital-based cross-sectional study was done between November 2015 and May 2018. Various clinical specimens were sampled from patients and analyzed for aerobic bacterial isolation and Kirby-Bauer disk diffusion susceptibility testing. Chi-square test was calculated to see association among variables, and -value <0.05 was taken as a cutoff value for statistical significance.
From the 716 clinical specimens processed, 134 (18.7%) were culture-positive for aerobic bacterial pathogens. Culture-confirmed positivity was higher in ear discharge (27.3%) and urine (26.3%) samples. The prevalence of infection was significantly highest among females ( = 0.001). 63 (47.4%) and 10 (7.4%) of spp. from Gram-negative bacteria were the predominant bacterial isolates, while 17 (12.6%) and 14 (10.4%) were from Gram-positive bacteria. Overall, 61.8% of the isolates were found to be MDR. The proportion of MDR among spp., and isolates was 90.9%, 60.9% and 50%, respectively. Gram-positive bacteria demonstrated 20%, 48.6% and 100% of resistance against norfloxacin, ciprofloxacin and clindamycin, respectively. Gram-negative bacteria also revealed from 20% resistance for the antibiotic nitrofurantoin and 100% of resistance for ampicillin and penicillin.
Infections with bacterial isolates resistant to the majority of antibiotics are a major issue in the study area. Most of the identified bacteria were resistant to the routinely used antibiotics, and MDR isolates are alarmingly high. Therefore, clinicians should practice rational choice of antibiotics and treatment should be guided by antimicrobial susceptibility testing.
耐多药(MDR)细菌感染对许多低收入国家构成严重威胁,这与抗生素的过度使用和滥用有关。本研究确定了从埃塞俄比亚西北部巴赫达尔甘比教学综合医院收治的患者不同身体部位感染中分离出的细菌的抗菌谱。
2015年11月至2018年5月进行了一项基于医院的横断面研究。从患者身上采集各种临床标本,进行需氧菌分离和 Kirby-Bauer 纸片扩散药敏试验分析。计算卡方检验以观察变量之间的关联,P值<0.05被用作具有统计学意义的临界值。
在处理的716份临床标本中,134份(18.7%)需氧菌病原体培养呈阳性。耳分泌物(27.3%)和尿液(26.3%)样本的培养确诊阳性率较高。女性感染患病率显著最高(P = 0.001)。革兰氏阴性菌中的大肠埃希菌属63株(47.4%)和肺炎克雷伯菌10株(7.4%)是主要的细菌分离株,而革兰氏阳性菌中的金黄色葡萄球菌17株(12.6%)和粪肠球菌14株(10.4%)是主要分离株。总体而言,61.8%的分离株被发现为耐多药。大肠埃希菌属、肺炎克雷伯菌和金黄色葡萄球菌分离株中的耐多药比例分别为90.9%、60.9%和50%。革兰氏阳性菌对诺氟沙星、环丙沙星和克林霉素的耐药率分别为20%、48.6%和100%。革兰氏阴性菌对呋喃妥因的耐药率为20%,对氨苄西林和青霉素的耐药率为100%。
对大多数抗生素耐药的细菌分离株感染是研究区域的一个主要问题。大多数鉴定出的细菌对常规使用的抗生素耐药,耐多药分离株数量惊人地高。因此,临床医生应合理选择抗生素,治疗应以药敏试验为指导。