非隧道式临时血液透析导管尖端细菌定植的模式与敏感性：索马里一家三级医院的结果

Pattern and Sensitivity of Bacterial Colonization on the Tip of Non-Tunneled Temporary Hemodialysis Catheters: Results of a Tertiary Hospital in Somalia.

作者信息

Mohamud Hussein Abdinafic, Kizilay Mehmet, Ali Nur Adam Abdirahim, Farah Yusuf Mohamud Mohamed, Dirie Abdirahman Mohamed Hassan, Hussein Mohamed Abdikarim, UÇaroĞlu Erhan

机构信息

Department of Cardiovascular Surgery, Mogadishu Somalia Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia.

Department of Microbiology and Infectious Diseases, Mogadishu Somalia Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia.

出版信息

Int J Gen Med. 2022 Aug 24;15:6775-6781. doi: 10.2147/IJGM.S379642. eCollection 2022.

DOI:10.2147/IJGM.S379642

PMID:36042934

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9420442/

Abstract

INTRODUCTION

Bacterial colonization on the tip of non-tunneled temporary hemodialysis catheters (NTHCs) and associated catheter-related infections (CRI) is a common complication in hemodialysis (HD) patients. In this study, we aimed to investigate the pattern of bacterial colonization formed on the tip of non-tunneled temporary hemodialysis catheters and their antibiotic sensitivity.

METHODS

This retrospective analysis was performed in the HD unit of an Education and Research Hospital that follows up a universe of approximately 300 patients, primarily from Mogadishu, Somalia. From September 2020 to September 2021, a total of 137 temporary HD catheters were removed and their tips were sent for culture after there was a suspicion of CRI and other sources of infection were excluded. HD Catheter tips were cultured semi-quantitatively, and the antibiogram of the positive cultures was studied.

RESULTS

Gram-positive cocci were found to be the most predominant bacterial organisms in positive cultures with 27 (31.0%) for , 9 (10.3%) for and 5 (5.7%) for . We found Enterococci to be 5.7% of the isolated microorganisms. Gram-negative pathogens isolated included 13 (14.9%) as the most common, followed by 10 (11.5%) and (4.6%). Methicillin-resistant (MRSA) was found to be 9.4%. Gram-positive isolates showed high sensitivity (100%) to Linezolid, Daptomycin, Vancomycin, and Tigecycline, but a low sensitivity rate to Oxacillin (41.2%). Gram-negative isolates had the highest sensitivity to Tigecycline (100%), Imipenem (88.9%), and Amikacin (87%) but low sensitivity to Ampicillin (4.8%), Trimethoprim/Sulfamethoxazole (TMP-SMX) (23.1%), and Ceftazidime (7.1%).

CONCLUSION

We conclude that each institution should have its own antibiogram in the management of HD CRIs. According to our findings in this study, we recommend intravenous Vancomycin and Imipenem as empirical therapy in patients with suspected HD CRIs.

摘要

引言

非隧道式临时血液透析导管（NTHC）尖端的细菌定植及相关导管相关感染（CRI）是血液透析（HD）患者常见的并发症。在本研究中，我们旨在调查非隧道式临时血液透析导管尖端形成的细菌定植模式及其抗生素敏感性。

方法

本回顾性分析在一家教育和研究医院的血液透析科进行，该科室对约300名患者进行随访，这些患者主要来自索马里摩加迪沙。从2020年9月至2021年9月，在怀疑发生CRI且排除其他感染源后，共移除了137根临时HD导管，并将其尖端送去培养。HD导管尖端进行半定量培养，并研究阳性培养物的抗菌谱。

结果

在阳性培养物中，革兰氏阳性球菌是最主要的细菌种类，其中金黄色葡萄球菌27株（31.0%），表皮葡萄球菌9株（10.3%），溶血葡萄球菌5株（5.7%）。我们发现肠球菌占分离出的微生物的5.7%。分离出的革兰氏阴性病原体中，大肠埃希菌最为常见，有13株（14.9%），其次是肺炎克雷伯菌10株（11.5%）和铜绿假单胞菌6株（4.6%）。耐甲氧西林金黄色葡萄球菌（MRSA）占9.4%。革兰氏阳性分离株对利奈唑胺、达托霉素、万古霉素和替加环素显示出高敏感性（100%），但对苯唑西林的敏感性较低（41.2%）。革兰氏阴性分离株对替加环素（100%）、亚胺培南（88.9%）和阿米卡星（87%）敏感性最高，但对氨苄西林（4.8%）、复方新诺明（TMP-SMX）（23.1%）和头孢他啶（7.1%）敏感性较低。