Médecins Sans Frontières - Operational Centre Brussels, Iraq Mission, Baghdad, Iraq.
Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
J Glob Antimicrob Resist. 2022 Sep;30:311-318. doi: 10.1016/j.jgar.2022.06.022. Epub 2022 Jun 26.
Iraq has suffered unrest and conflicts in the past decades, leaving behind a weakened healthcare system. In 2018, Médecins Sans Frontières (MSF) opened a tertiary orthopaedic care centre in Mosul providing reconstructive surgery with access to microbiological analysis.
A retrospective cross-sectional analysis of microbiological and clinical data of patients admitted between April 2018 and December 2019.
There were 174 patients who were included in this study; there were more males than females (135 to 38, respectively), and the mean age was 32.6 y. Of the 174 patients, the majority had more than one bacterial isolate detected (n = 122, 70.1%); 141 (81.0%) had at least one multidrug-resistant (MDR) isolate detected during their hospital stay. Staphylococcus aureus (n = 197, 48.2%) was the most common organism isolated. Overall, most isolates detected were MDR (n = 352, 86%), mostly methicillin-resistant S. aureus (n = 186, 52.8%) or extended-spectrum beta-lactamase-producing Enterobacterales (n = 117, 33.2%). Among patients admitted to the operating department (n = 111, 63.7%), 81.1% (n = 90) were admitted for violent trauma injuries. Patients who had more than one procedure performed per surgery had significantly increased odds of having at least one MDR organism isolated (OR 8.66, CI 1.10-68.20, P = 0.03).
This study describes a high prevalence of antibiotic resistance in patients with trauma-related wounds in Mosul, Iraq. It highlights the importance of microbiological analysis and ongoing surveillance to provide optimal treatment. Additionally, it underscores the importance of infection prevention and control measures as well as antibiotic stewardship.
伊拉克在过去几十年中经历了动荡和冲突，留下了一个脆弱的医疗体系。2018 年，无国界医生组织（MSF）在摩苏尔开设了一家三级骨科治疗中心，提供重建手术，并可进行微生物分析。
对 2018 年 4 月至 2019 年 12 月期间收治的患者的微生物和临床数据进行回顾性横断面分析。
本研究共纳入 174 例患者；男性多于女性（分别为 135 例和 38 例），平均年龄为 32.6 岁。在 174 例患者中，大多数患者检测到一种以上的细菌分离株（n=122，70.1%）；在住院期间，有 141 例（81.0%）至少检测到一种耐多药（MDR）分离株。金黄色葡萄球菌（n=197，48.2%）是最常见的分离菌。总的来说，大多数分离物均为 MDR（n=352，86%），主要为耐甲氧西林金黄色葡萄球菌（n=186，52.8%）或产超广谱β-内酰胺酶的肠杆菌科（n=117，33.2%）。在收入手术室的患者（n=111，63.7%）中，81.1%（n=90）因暴力创伤受伤入院。每例手术进行多次手术的患者，其至少有一种 MDR 分离株的可能性显著增加（OR 8.66，95%CI 1.10-68.20，P=0.03）。
本研究描述了伊拉克摩苏尔创伤相关伤口患者中抗生素耐药率较高。它强调了微生物分析和持续监测的重要性，以提供最佳治疗。此外，它还强调了感染预防和控制措施以及抗生素管理的重要性。
