Adan Faduma Nur, Jeele Mohamed Osman Omar, Omar Nasteho Mohamed Sheikh
Department of Infectious Diseases, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia.
Department of Internal Medicine, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia.
Infect Drug Resist. 2022 Oct 31;15:6297-6305. doi: 10.2147/IDR.S387370. eCollection 2022.
There is a lack of data concerning hospital-acquired pneumonia (HAP) due to multidrug resistant non-fermentative gram-negative bacilli (MDR-NFGNB) in Somalia, and this study will aim to analyze the epidemiology of MDR-NFGNB among HAP patients in tertiary care hospital in Somalia.
This is a retrospective study which evaluated the presence of MDR-NFGNB among 2003 HAP patients between June 2017 and May 2022 in a tertiary care hospital in Somalia. NFGNB were cultured on blood agar and eosin methylene blue agar and were then used BBL crystal system and oxidase biochemical assays for identification. Antimicrobial sensitivity and resistance were assessed using Mueller-Hinton agar.
A total of 160 confirmed cases of HAP due to NFGNB were examined. Among these, 114 (71%) were males compared to females (n = 46, 29%). The mean age was 49.49 ± 21.48. The overall prevalence rate of NFGNB among patients with HAP was 8%. It was more common in older patients and in patients with co-morbidities. was the most common NFGNB with n = 93 (58%), followed by (n = 55, 34%), and (n = 12, 8%). Regarding the antimicrobial sensitivity rate, showed an overall resistance level of 82%, (81%), and (62%). The rate of CR-NFGNB in our study was 79.4%. We found that 68.1% of NFGNB was multidrug resistant (MDR) pathogens. MDR patterns were more common in infections (84%). MDR pathogens were strongly associated with ICU admissions (95% CI, 0.202-0.800, OR, 0.402, value <0.009). Finally, the mortality rate of HAP caused by NFGNB in our study was 42.5%.
The prevalence of NFGNB in HAP patients was 8%. These infections were more prevalent among men and the elderly. and exhibited the highest antibiotic resistance rate. The MDR level of these pathogens was 68.1%.
索马里缺乏关于多重耐药非发酵革兰氏阴性杆菌（MDR-NFGNB）所致医院获得性肺炎（HAP）的数据，本研究旨在分析索马里一家三级医院HAP患者中MDR-NFGNB的流行病学情况。
这是一项回顾性研究，评估了2017年6月至2022年5月期间索马里一家三级医院2003例HAP患者中MDR-NFGNB的存在情况。非发酵革兰氏阴性杆菌在血琼脂和伊红美蓝琼脂上培养，然后使用BBL晶体系统和氧化酶生化试验进行鉴定。使用穆勒-欣顿琼脂评估抗菌敏感性和耐药性。
共检查了160例确诊的由非发酵革兰氏阴性杆菌引起的HAP病例。其中，男性114例（71%），女性46例（29%）。平均年龄为49.49±21.48岁。HAP患者中非发酵革兰氏阴性杆菌的总体患病率为8%。在老年患者和合并症患者中更为常见。铜绿假单胞菌是最常见的非发酵革兰氏阴性杆菌，有93例（58%），其次是鲍曼不动杆菌（55例，34%）和嗜麦芽窄食单胞菌（12例，8%）。关于抗菌敏感性率，铜绿假单胞菌的总体耐药水平为82%，鲍曼不动杆菌为81%，嗜麦芽窄食单胞菌为62%。我们研究中CR-NFGNB的发生率为79.4%。我们发现68.1%的非发酵革兰氏阴性杆菌是多重耐药（MDR）病原体。MDR模式在铜绿假单胞菌感染中更为常见（84%）。MDR病原体与入住重症监护病房密切相关（95%CI，0.202 - 0.800，OR，0.402，P值<0.009）。最后，我们研究中由非发酵革兰氏阴性杆菌引起的HAP死亡率为42.5%。
HAP患者中非发酵革兰氏阴性杆菌的患病率为8%。这些感染在男性和老年人中更为普遍。铜绿假单胞菌和鲍曼不动杆菌表现出最高的抗生素耐药率。这些病原体的MDR水平为68.1%。
