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危重症医院获得性感染患者中出现高抗菌药物耐药性。

Emergence of High Antimicrobial Resistance among Critically Ill Patients with Hospital-Acquired Infections in a Tertiary Care Hospital.

机构信息

Clinical Pharmacy Department, Faculty of Pharmacy, October 6 University, Giza 12585, Egypt.

Microbiology and Immunology Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62514, Egypt.

出版信息

Medicina (Kaunas). 2022 Nov 4;58(11):1597. doi: 10.3390/medicina58111597.

DOI:10.3390/medicina58111597
PMID:36363554
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9698311/
Abstract

: Inappropriate antibiotic usage in hospitalized patients contributes to microbial resistance. Our study aimed to examine the incidence of clinical bacterial isolates and their antibiotic resistance burden among critically ill patients in different hospital units. : A single-centered cross-sectional study was conducted in a 120-bed tertiary care hospital that included 221 critically ill patients with hospital-acquired infections. Bacterial cultures and sensitivity reports were obtained and followed by a formal analysis of the antibiogram results to explore recovered isolates' prevalence and antibiotic susceptibility patterns. : Gram-negative bacteria were the most predominant pathogens among recovered isolates from the various hospital units (71%). sp. was the most prevalent microbe, followed by sp., with an incidence level of 28% and 16.2%, respectively. Among the Gram-positive organisms, the coagulase-negative were the most predominant organism (11.3%), while (6.3%) methicillin-resistant (MRSA) isolates were recovered from different hospital units. Antibiotic sensitivity testing showed that polymyxin B was the most effective antibiotic against Gram-negative bacteria, whereas vancomycin and linezolid were the most active antibiotics against Gram-positive pathogens. Moreover, 7% of the Gram-negative bacteria isolated from different units showed positive production of extended-spectrum beta-lactamase (ESBL). The current study describes the high antibiotic resistance patterns in various hospital units that need extra legislation to prevent healthcare providers from misprescription and overuse of antibiotics.

摘要

住院患者中不适当的抗生素使用导致了微生物耐药性的产生。我们的研究旨在检查不同医院科室重症患者中临床分离细菌的发生率及其抗生素耐药负担。

这是一项在一家拥有 120 张床位的三级保健医院进行的单中心横断面研究,包括 221 例医院获得性感染的重症患者。我们获得了细菌培养和药敏报告,并对药敏结果进行了正式分析,以探讨分离株的流行率和抗生素敏感性模式。

在不同医院科室分离的细菌中,革兰氏阴性菌是最主要的病原体(71%)。 sp. 是最常见的微生物,其次是 sp. ,其发生率分别为 28%和 16.2%。在革兰氏阳性菌中,凝固酶阴性 是最主要的病原体(11.3%),而不同医院科室分离的 (MRSA)耐甲氧西林金黄色葡萄球菌(6.3%)。抗生素药敏试验表明,多粘菌素 B 是对抗革兰氏阴性菌最有效的抗生素,而万古霉素和利奈唑胺是对抗革兰氏阳性病原体最有效的抗生素。此外,从不同科室分离的 7%的革兰氏阴性菌表现出对扩展型β-内酰胺酶(ESBL)的阳性生产。本研究描述了各医院科室中存在的高抗生素耐药模式,需要额外的立法来防止医疗保健提供者的处方不当和抗生素的过度使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b876/9698311/f322afd4b9e6/medicina-58-01597-g008.jpg
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