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南非西南部社区获得性耐甲氧西林金黄色葡萄球菌的分布和抗生素耐药模式。

Distribution and Antibiotics Resistance Pattern of Community-Acquired Methicillin-Resistance Staphylococcus aureus in Southwestern Nigeria.

机构信息

Department of Medical Microbiology and Parasitology, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.

出版信息

Adv Exp Med Biol. 2022;1369:81-91. doi: 10.1007/5584_2021_658.

Abstract

BACKGROUND

Methicillin-resistant Staphylococcus aureus is a global public health challenge and there is a continuous increase in community-acquired infections among people in different geographical location. We sought the distribution and antibiotics pattern of community-acquired methicillin-resistant Staphylococcus isolates among apparently healthy residents of Ibadan, Southwestern Nigeria.

METHODS

Seven hundred (700) healthy volunteers residing in Ibadan metropolis, Nigeria, were enrolled in this study. Isolates from the nasal swabs were aseptically collected and characterized using standard and established microbiological methods, which included growth and fermentation on mannitol salt agar, colonial morphology, Gram-staining reaction, Microbact™ 12S identification kit and confirmed with 16SrRNA. After identification of the isolates, antimicrobial susceptibility test was performed on Mueller-Hinton agar by modified Kirby-Bauer disc diffusion method and the presence of mecA and nuc genes were detected via polymerase chain reaction assay.

RESULTS

Prevalence of Staphylococcus aureus nasal carriage and Methicillin-resistant Staphylococcus in this study was 31.9% and 9.43% respectively. The residents of Ibadan North local government area (Fisher's Exact = 1.8962, P = .028) and Egbeda local government area (Fisher's Exact = 2.7222, P = .006) are likely to carry Methicillin-resistant Staphylococcus than any other local government area in Ibadan, Nigeria. The antimicrobial resistance patterns of the isolates revealed high resistance to Oxacillin (96.9%). Most of the isolates were sensitive to vancomycin (92.4%). Polymerase chain reaction analysis showed that mecA gene was present in all 66 (100%) Methicillin-resistant Staphylococcus aureus isolates. Male-gender (ϰ = 8.849, P = .003), Adults; 40-50 years old (ϰ = 9.842, P = .002), low educational background (ϰ = 36.817, P ˂ .001), recent hospital visitation (ϰ = 8.693, P = .003) are some of the factors that are observed in this study to be associated with Methicillin-resistant Staphylococcus infection.

CONCLUSION

Our findings revealed the relatively high frequency of nasal carriers of Methicillin-resistant Staphylococcus aureus among the apparently healthy residents of the studied area and the advent of multidrug resistance among these isolates. Our study also supports previous findings on male-gender and low educational background as risk factors of S. aureus carriage. The need for rational chemotherapy, routine detection and regular surveillance of Methicillin-resistant Staphylococcus to limit its spread and reduce treatment failures is important.

摘要

背景

耐甲氧西林金黄色葡萄球菌是一个全球性的公共卫生挑战,不同地理位置的人群中社区获得性感染不断增加。我们旨在研究尼日利亚西南部伊巴丹市健康居民中社区获得性耐甲氧西林金黄色葡萄球菌分离株的分布和抗生素模式。

方法

本研究纳入了 700 名居住在尼日利亚伊巴丹大都市的健康志愿者。无菌采集鼻拭子分离株,并使用标准和已建立的微生物学方法进行特征鉴定,包括甘露醇盐琼脂上的生长和发酵、菌落形态、革兰氏染色反应、Microbact™ 12S 鉴定试剂盒,并通过 16SrRNA 进行确认。分离株鉴定后,采用改良 Kirby-Bauer 纸片扩散法在 Mueller-Hinton 琼脂上进行抗菌药物敏感性试验,并通过聚合酶链反应检测 mecA 和 nuc 基因的存在。

结果

本研究中,金黄色葡萄球菌鼻携带率和耐甲氧西林金黄色葡萄球菌的检出率分别为 31.9%和 9.43%。伊巴丹市北地方政府区(Fisher's Exact = 1.8962,P =.028)和 Egbeda 地方政府区(Fisher's Exact = 2.7222,P =.006)的居民比尼日利亚伊巴丹的任何其他地方政府区更有可能携带耐甲氧西林金黄色葡萄球菌。分离株的抗菌药物耐药模式显示对苯唑西林高度耐药(96.9%)。大多数分离株对万古霉素敏感(92.4%)。聚合酶链反应分析显示,所有 66 株(100%)耐甲氧西林金黄色葡萄球菌分离株均存在 mecA 基因。男性(ϰ=8.849,P =.003)、40-50 岁(ϰ=9.842,P =.002)、低教育背景(ϰ=36.817,P<.001)、近期医院就诊(ϰ=8.693,P =.003)是本研究中观察到与耐甲氧西林金黄色葡萄球菌感染相关的一些因素。

结论

我们的研究结果显示,在所研究地区的健康居民中,耐甲氧西林金黄色葡萄球菌的鼻携带率相对较高,且这些分离株出现了多药耐药性。我们的研究还支持先前关于男性和低教育背景是金黄色葡萄球菌携带风险因素的发现。合理化疗、常规检测和定期监测耐甲氧西林金黄色葡萄球菌以限制其传播和减少治疗失败的重要性。

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