埃塞俄比亚南部阿尔巴明奇综合医院疑似手术部位感染的骨科手术患者的细菌学特征、抗菌药物敏感性模式及相关因素
Bacteriological Profiles, Antimicrobial Susceptibility Patterns, and Associated Factors in Patients Undergoing Orthopedic Surgery with Suspicion of Surgical Site Infection at Arba Minch General Hospital in Southern Ethiopia.
作者信息
Alelign Dagninet, Tena Teshome, Tadesse Dagimawie, Tessema Moges, Seid Mohamed, Oumer Yisiak, Aklilu Addis, Beyene Kassaw, Bekele Alehegn, Abebe Getachew, Alemu Mathewos
机构信息
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
School of Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
出版信息
Infect Drug Resist. 2022 May 9;15:2427-2443. doi: 10.2147/IDR.S367510. eCollection 2022.
BACKGROUND
In the thoughts of all orthopedicians, the emergence of drug-resistant and biofilm-forming bacterial infections at orthopedic surgical sites is the most feared problem. Thus, this study aimed to determine the bacteriological profiles, antimicrobial susceptibility patterns, and biofilm forming ability of isolates, as well as factors associated with orthopedic surgical site infections (OSSIs).
METHODS
An institution-based cross-sectional study was conducted from March 1st, 2021, to February 30th, 2022 at Arba Minch General Hospital. About 245 suspected orthopedic patients with surgical site infection were enrolled and structured questionnaires were used to collect the required information. Wound swabs or pus aspirates were aseptically collected. The frequency and type of bacterial pathogen(s), antimicrobial susceptibility pattern, and biofilm formation were used to determine and characterize the magnitude of OSSIs. SPSS version 25 was used to analyze factors associated with OSSIs.
RESULTS
The overall magnitude of symptomatic OSSIs was 29.4% (72/245). External fixation [AOR = 4.761, 95% CI: (1.108-20.457)], implant use [AOR = 3.470, 95% CI: (1.460-8.246)], length of time for surgery [AOR = 3.225, 95% CI: (1.545-6.731)], and post-operative hospitalization [AOR = 4.099, 95% CI: (2.026-8.293)] were all statistically significant. was the most frequently isolated bacteria, accounting for 76%. Methicillin-resistant was observed in 57.9% and 40% of isolated (MRSA) and coagulase-negative (CoNS), respectively. One-third of the isolated was vancomycin-resistant (VRE). Overall, 67.1% (51/76) of isolates were multidrug-resistant (MDR). About 27.6% (21/76) of isolates were found to be strong biofilm producers.
CONCLUSION
OSSIs were shown to be caused by a significant number of drug-resistant and biofilm-producing bacterial isolates. To mitigate the problem, aseptic surgical practice and conventional wound management, as well as constant observation of antimicrobial resistant patterns, should be followed.
背景
在所有骨科医生的认知中，骨科手术部位出现耐药且形成生物膜的细菌感染是最令人担忧的问题。因此，本研究旨在确定分离菌株的细菌学特征、抗菌药敏模式和生物膜形成能力，以及与骨科手术部位感染（OSSI）相关的因素。
方法
于2021年3月1日至2022年2月30日在阿尔巴明奇综合医院开展了一项基于机构的横断面研究。纳入了约245例疑似有手术部位感染的骨科患者，并使用结构化问卷收集所需信息。无菌采集伤口拭子或脓液抽吸物。通过细菌病原体的频率和类型、抗菌药敏模式以及生物膜形成情况来确定和描述OSSI的严重程度。使用SPSS 25版软件分析与OSSI相关的因素。
结果
有症状的OSSI总体发生率为29.4%（72/245）。外固定[AOR = 4.761，95% CI：（1.108 - 20.457）]、植入物的使用[AOR = 3.470，95% CI：（1.460 - 8.246）]、手术时长[AOR = 3.225，95% CI：（1.545 - 6.731）]以及术后住院时间[AOR = 4.099，95% CI：（2.026 - 8.293）]均具有统计学意义。 是最常分离出的细菌，占76%。在分离出的金黄色葡萄球菌（MRSA）和凝固酶阴性葡萄球菌（CoNS）中，耐甲氧西林的比例分别为57.9%和40%。三分之一的分离菌株对万古霉素耐药（VRE）。总体而言，67.1%（51/76）的分离菌株对多种药物耐药（MDR）。约27.6%（21/76）的分离菌株被发现是强生物膜产生菌。
结论
研究表明，大量耐药且产生生物膜的细菌分离株会导致OSSI。为缓解这一问题，应遵循无菌手术操作和常规伤口处理方法，并持续观察抗菌耐药模式。
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