Tilahun Mihret
Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
Infect Drug Resist. 2022 Jul 26;15:3949-3965. doi: 10.2147/IDR.S376622. eCollection 2022.
Antibiotic resistance is becoming a global issue, with estimated 2.8 million people in the United States developing antibiotic-resistant diseases each year. The carriage of ESBL and Carbapenemase-producing Enterobacteriaceae among hospitalized patients is a threat to the future of antibiotic treatment.
Multi-drug resistance profile, prevalence of extended-spectrum beta-lactamase and Carbapenemase-producing Gram-negative bacilli among admitted patients after surgery with suspected surgical site nosocomial infection north east Ethiopia.
A hospital-based cross-sectional study was conducted from April 2021 to February 2022. Socio-demographic and clinical data were assessed using a structured questionnaire. A total of 384 relevant clinical samples (pus, pus aspirates, and wound swabs) were collected aseptically and processed within 30 min by placing the swabs into the sterile test tubes having 0.5 mL of sterile normal saline. The samples were cultured on MacConkey agar, chocolate agar and blood agar, and species identification was done using standard biochemical tests. Disk diffusion antimicrobial sensitivity test was done on Mueller-Hinton agar. All the cefoxitin resistant Enterobacteriaceae isolates were checked for the presence of AmpC beta-lactamase using four cartridges of disk diffusion tablets. ESBL output validation was conducted by the combination disk test. The production of Carbapenemase was checked using modified carbapenem inactivation method.
The prevalence of significant bacterial nosocomial infection among surgical site infection 343 (89.32%). S. 125 (36.4%) was predominant followed by 80 (23.3%) 31 (9.03%). The overall MDR rate of isolated bacteria was 251 (73.3%). About 150 (73.9%) bacteria were suspected for ESBL production and 67 (33%) AmpC beta-lactamase and 27 (13.3%) Carbapenemase-producing Gram-negative bacterial, respectively.
The severity of ESBL-PE was critical, and the CPE was alarming. Meropenem and imipenem were the most effective antibiotics against ESBL-producing Enterobacteriaceae. Therefore, strict infection prevention and control measures are needed.
抗生素耐药性正成为一个全球性问题，据估计，美国每年有280万人患上抗生素耐药性疾病。住院患者中产超广谱β-内酰胺酶（ESBL）和碳青霉烯酶的肠杆菌科细菌的携带情况，对抗生素治疗的未来构成了威胁。
了解埃塞俄比亚东北部疑似手术部位医院感染的术后入院患者中多重耐药情况、产超广谱β-内酰胺酶和碳青霉烯酶的革兰氏阴性杆菌的流行情况。
于2021年4月至2022年2月进行了一项基于医院的横断面研究。使用结构化问卷评估社会人口统计学和临床数据。共无菌采集384份相关临床样本（脓液、脓液抽吸物和伤口拭子），并在30分钟内将拭子放入含有0.5 mL无菌生理盐水的无菌试管中进行处理。样本在麦康凯琼脂、巧克力琼脂和血琼脂上培养，并使用标准生化试验进行菌种鉴定。在 Mueller-Hinton 琼脂上进行纸片扩散法抗菌药敏试验。使用四盒纸片扩散片对所有对头孢西丁耐药的肠杆菌科分离株进行AmpCβ-内酰胺酶检测。通过组合纸片试验进行ESBL产量验证。使用改良碳青霉烯灭活法检测碳青霉烯酶的产生情况。
手术部位感染中严重细菌医院感染的患病率为343例（89.32%）。金黄色葡萄球菌125例（36.4%）占主导，其次是大肠埃希菌80例（23.3%）、肺炎克雷伯菌31例（9.03%）。分离细菌的总体多重耐药率为251例（73.3%）。分别有150例（73.9%）细菌疑似产ESBL，67例（33%）产AmpCβ-内酰胺酶，27例（13.3%）产碳青霉烯酶的革兰氏阴性菌。
产ESBL肠杆菌科细菌的情况严重，产碳青霉烯酶肠杆菌科细菌的情况令人担忧。美罗培南和亚胺培南是对抗产ESBL肠杆菌科细菌最有效的抗生素。因此，需要采取严格的感染预防和控制措施。
