Wekesa Yvonne N, Namusoke Fatuma, Sekikubo Musa, Mango Dennis Wandera, Bwanga Freddie
Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, Kampala, Uganda.
MBN Clinical Laboratories, Kampala, Uganda.
SAGE Open Med. 2020 Nov 10;8:2050312120970719. doi: 10.1177/2050312120970719. eCollection 2020.
The aim of this study was to determine the proportion and mechanism of resistance to ceftriaxone and ceftazidime among species and and examine the burden of methicillin-resistant from caesarean section surgical site infections in Uganda.
Wound swabs from 109 caesarean section surgical site infections were cultured for pathogenic bacteria following standard microbiological procedures. The Kirby-Bauer disc diffusion technique was used for antimicrobial susceptibility testing. Methicillin-resistant diagnosis was based on polymerase chain reaction testing for the gene. Data were analysed using SPSS-IBM Statistics v.20.
A total of 118 pathogens were recovered from 93 (85%) of 109 surgical site infections swabs. Of the 118 pathogens, gram-negative bacteria were 69 (58.5%), including 44 (37.3%) species, 11 (9.3%) , 6 (5.1%) species, and 8 (6.8%) other gram-negative bacteria. In total, 49 of the 118 pathogens were gram-positive bacteria, including 34 (28.8%) and 15 (12.7%) species. Resistance to ceftriaxone was detected in all 11 (100%) of the and in 43 (97.7%) of the 44 species and to ceftazidime in all 11 (100%) of the and 40 (91%) of the 44 species. Extended-spectrum beta-lactamase explained resistance to ceftazidime in 10 (91%) of the 11 and 19 (48%) of the 40 species. Carbapenemase production explained 15 (38%) of the 40 ceftazidime-resistant species. Methicillin-resistant was detected in 91% of .
species, , and -majority methicillin-resistant dominated the pathogens in caesarean section surgical site infections. Almost all of the and species were resistant to ceftriaxone or ceftazidime. Extended-spectrum beta-lactamase was the underlying resistance mechanism among almost all of the ceftriaxone- or ceftazidime-resistant However, this mechanism accounted for less than half of ceftriaxone- or ceftazidime-resistant species, where carbapenemases accounted for 40% of the resistance, a finding previously unreported in Uganda.
本研究旨在确定[具体物种]中对头孢曲松和头孢他啶耐药的比例及机制，并调查乌干达剖宫产手术部位感染中产耐甲氧西林[具体物种]的负担。
按照标准微生物学程序，对109例剖宫产手术部位感染的伤口拭子进行病原菌培养。采用 Kirby-Bauer 纸片扩散法进行药敏试验。耐甲氧西林[具体物种]的诊断基于对[具体基因]的聚合酶链反应检测。使用SPSS-IBM Statistics v.20软件进行数据分析。
从109例手术部位感染拭子中的93例（85%）共分离出118株病原菌。在这118株病原菌中，革兰氏阴性菌有69株（58.5%），包括44株（37.3%）[具体物种]、11株（9.3%）[具体物种]、6株（5.1%）[具体物种]和8株（6.8%）其他革兰氏阴性菌。118株病原菌中共有49株革兰氏阳性菌，包括34株（28.8%）[具体物种]和15株（12.7%）[具体物种]。所有11株（100%）[具体物种]和44株[具体物种]中的43株（97.7%）对头孢曲松耐药，所有11株（100%）[具体物种]和44株[具体物种]中的40株（91%）对头孢他啶耐药。超广谱β-内酰胺酶解释了11株[具体物种]中的10株（91%）和40株[具体物种]中的19株（48%）对头孢他啶的耐药性。碳青霉烯酶的产生解释了40株对头孢他啶耐药的[具体物种]中的15株（38%）。在91%的[具体物种]中检测到耐甲氧西林[具体物种]。
[具体物种]、[具体物种]和多数耐甲氧西林[具体物种]在剖宫产手术部位感染的病原菌中占主导地位。几乎所有的[具体物种]和[具体物种]对头孢曲松或头孢他啶耐药。超广谱β-内酰胺酶是几乎所有对头孢曲松或头孢他啶耐药的[具体物种]的潜在耐药机制。然而，该机制在对头孢曲松或头孢他啶耐药的[具体物种]中占比不到一半，其中碳青霉烯酶占耐药性的40%，这一发现此前在乌干达未见报道。
