KIST Medical College and Teaching Hospital, Mahalaxmi-1, Lalitpur, Nepal.
Department of Microbiology, KIST Medical College and Teaching Hospital, Mahalaxmi-1, Lalitpur, Nepal.
JNMA J Nepal Med Assoc. 2021 Sep 11;59(241):853-857. doi: 10.31729/jnma.5957.
Antimicrobial-resistant Acinetobacter species are implicated in a variety of infections including nosocomial bacteraemia, secondary meningitis, and urinary tract infections. Carbapenem including meropenem-resistant Acinetobacter is recognized as one of the most difficult antimicrobial resistant gram-negative bacilli to control and treat. It was classified as an urgent threat by Centers for Disease Control and Prevention in 2019 Antibiotic Resistance Threats Report. This study was carried out to determine the prevalence of meropenem resistance among acinetobacter positive clinical samples in a tertiary care centre.
A descriptive cross-sectional study was carried out in microbiology department of Clinical Laboratory Services among Acinetobacter positive clinical samples of a tertiary care center in Nepal. The culture and sensitivity reports of various clinical samples from April 2018 to April 2020 which were positive for Acinetobacter species were taken from hospital records section. Convenience sampling was done. Meropenem-resistant Acinetobacter samples were studied. Ethical approval was received from Institutional Review Committee (Ref No. 076/77/40). Analysis of data was done using Statistical Package for the Social Sciences version 26. Point estimate at 95% Confidence Interval calculated with frequency.
Out of 121 Acinetobacter isolates, prevalence of meropenem-resistant Acinetobacter was reported in 93 (76.9%) at 95% Confidence Interval (69.39-84.40). Among the meropenem-resistant Acinetobacter samples, most of the samples were collected from the sputum 70 (75.2%) followed by blood 8 (8.6%).
High prevalence of meropenem-resistant Acinetobacter species in our hospital setting is alarming. In addition, there is emergence of resistance against even the last resort drugs which is creating a treatment crisis.
耐抗生素不动杆菌种与多种感染有关，包括医院获得性菌血症、继发性脑膜炎和尿路感染。耐碳青霉烯类抗生素的不动杆菌被认为是最难控制和治疗的最困难的抗微生物革兰氏阴性杆菌之一。2019 年，疾病控制与预防中心在《抗生素耐药性威胁报告》中将其列为紧急威胁。本研究旨在确定三级保健中心耐美罗培南不动杆菌阳性临床标本的流行率。
在尼泊尔一家三级保健中心的临床实验室服务部微生物学部门进行了一项描述性横断面研究。从医院记录科获取了 2018 年 4 月至 2020 年 4 月期间各种临床样本的培养和药敏报告，这些样本均为不动杆菌阳性。采用便利抽样法。研究了耐美罗培南不动杆菌样本。本研究获得了机构审查委员会的伦理批准（注册号 076/77/40）。使用社会科学统计软件包 26 版对数据进行分析。使用频率计算点估计值和 95%置信区间。
在 121 株不动杆菌分离株中，93 株（76.9%，95%置信区间[69.39-84.40]）报告了耐美罗培南不动杆菌的流行率。在耐美罗培南不动杆菌样本中，大部分样本来自痰液 70 份（75.2%），其次是血液 8 份（8.6%）。
我们医院环境中耐美罗培南不动杆菌的高流行率令人警惕。此外，甚至对最后手段的药物也出现了耐药性，这正在造成治疗危机。
