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埃塞俄比亚西南部梅楚卡尔转诊医院住院患者中耐甲氧西林金黄色葡萄球菌和耐万古霉素金黄色葡萄球菌的高流行率。

High prevalence of MRSA and VRSA among inpatients of Mettu Karl Referral Hospital, Southwest Ethiopia.

机构信息

Department of Biology, Mettu University, Mettu, Ethiopia.

出版信息

Trop Med Int Health. 2022 Aug;27(8):735-741. doi: 10.1111/tmi.13789. Epub 2022 Jul 25.

Abstract

OBJECTIVE

To assess the prevalence of methicillin and vancomycin-resistant Staphylococcus aureus among patients admitted to Mettu Karl Referral Hospital.

METHODS

A cross-sectional study was conducted to study the point prevalence of MRSA and VRSA. A total of 384 patients (male = 201 and female = 183) admitted to medical (109), paediatric (109) and surgical (166) wards of Mettu Karl Referral Hospital from November 2019 to April 2020 were included in the study. We studied 384 samples (166 wound swabs and 218 nasal swabs) collected from inpatients. Staphylococcus aureus was isolated, characterised and identified based on morphological and biochemical features and confirmed by PCR amplification of the nuc gene. The isolates were checked against 12 antibiotics, and MRSA isolates were primarily identified using cefoxitin (30 μg) and confirmed by amplification of mecA gene. Staphylococcus aureus resistance to Vancomycin was tested by the broth microdilution method.

RESULTS

The rate of isolation of Staphylococcus aureus was 32.8% (126/384). The point prevalence of MRSA and VRSA from clinical specimens was 18.8% (72/384) and 2.6% (10/384), respectively. Of 126 Staphylococcus aureus isolated, 57.1% (72) were MRSA and 7.9% (10) were VRSA. Of the 166 samples collected from patients in the surgical ward, the rates of isolation of MRSA and VRSA were 21.1% (35/166) and 4.8% (8/166), respectively. A high rate of isolation of MRSA and VRSA was recorded among patients admitted to surgical wards compared with medical and paediatric wards.

CONCLUSIONS

This study showed a high prevalence of MRSA and VRSA in the hospital. Proper implementation of infection control practices and investigation of underlying risk factors are urgently needed to mitigate the further spread of the pathogen.

摘要

目的

评估梅楚卡尔转诊医院住院患者中耐甲氧西林和万古霉素金黄色葡萄球菌的流行情况。

方法

本横断面研究旨在研究耐甲氧西林金黄色葡萄球菌和万古霉素耐药金黄色葡萄球菌的时点患病率。2019 年 11 月至 2020 年 4 月期间,我们共纳入了 384 名(男 201 名,女 183 名)入住梅楚卡尔转诊医院内科(109 名)、儿科(109 名)和外科(166 名)病房的患者,研究了从住院患者中采集的 384 个样本(166 个伤口拭子和 218 个鼻腔拭子)。我们根据形态学和生化特征分离、鉴定和识别金黄色葡萄球菌,并通过 nuc 基因的 PCR 扩增进行确认。将分离株与 12 种抗生素进行检测,使用头孢西丁(30μg)初步鉴定耐甲氧西林金黄色葡萄球菌,并通过 mecA 基因扩增进行确认。通过肉汤微量稀释法检测金黄色葡萄球菌对万古霉素的耐药性。

结果

金黄色葡萄球菌的分离率为 32.8%(126/384)。临床标本中耐甲氧西林金黄色葡萄球菌和万古霉素耐药金黄色葡萄球菌的时点患病率分别为 18.8%(72/384)和 2.6%(10/384)。在分离的 126 株金黄色葡萄球菌中,耐甲氧西林金黄色葡萄球菌占 57.1%(72 株),万古霉素耐药金黄色葡萄球菌占 7.9%(10 株)。在从外科病房采集的 166 个样本中,耐甲氧西林金黄色葡萄球菌和万古霉素耐药金黄色葡萄球菌的分离率分别为 21.1%(35/166)和 4.8%(8/166)。与内科和儿科病房相比,外科病房住院患者中耐甲氧西林金黄色葡萄球菌和万古霉素耐药金黄色葡萄球菌的分离率较高。

结论

本研究显示医院耐甲氧西林金黄色葡萄球菌和万古霉素耐药金黄色葡萄球菌的流行率较高。迫切需要适当实施感染控制措施并调查潜在的危险因素,以减轻病原体的进一步传播。

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