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加纳北部地区细菌感染的流行病学和与多药耐药相关的因素。

Bacterial infections epidemiology and factors associated with multidrug resistance in the northern region of Ghana.

机构信息

Department of Social and Behavioral Change, School of Public Health, University for Development Studies, Tamale, Ghana.

Zonal Public Health Reference Laboratory, Tamale, Ghana.

出版信息

Sci Rep. 2022 Dec 21;12(1):22069. doi: 10.1038/s41598-022-26547-7.

Abstract

Bacterial infections caused by multidrug resistant organisms are a major global threat. There is still a knowledge gap on this situation in the Northern Region of Ghana. This study determined the prevalence and resistance profile of bacterial infections. It also identified factors associated with multidrug resistance in the study area. This was a retrospective cross-sectional design and it analyzed data from the samples received at the Tamale Zonal Public Health Reference Laboratory from June 2018 to May 2022. The data were analyzed using the R software version 4.2.0. Univariate and multivariable binary logistic regression analyses were used to determine the factors associated with multidrug resistance. The samples included all specimen types possible. The specimens were collected for the purpose of clinical bacteriology diagnostics. Overall a total of 1222 isolates were obtained. The three (3) main bacteria responsible for infections were: Klebsiella spp. (27%), Moraxella spp. (22%), Escherichia spp. (16%). High resistance levels were found against the tested antibiotics and about 41.60% of the bacterial strains isolated were multidrug resistant. Hospitalization was associated with multidrug resistance in univariate (COR 1.96; 95% CI 1.43-2.71; P-value < 0.001) and multivariable analyses (AOR 1.78; 95% CI 1.28-2.49; P-value < 0.001). There is the need for further research on the molecular epidemiology of antibiotic resistance genes in the study area to effectively control the spread of multidrug resistant pathogens. In addition, efforts to build the capacity of health professionals on infection prevention and control as well as diagnostic and antimicrobial stewardship needs urgent attention.

摘要

耐多药生物体引起的细菌感染是一个主要的全球威胁。加纳北部地区在这方面的知识仍然存在差距。本研究旨在确定细菌感染的流行情况和耐药谱,并确定研究区域中与多药耐药相关的因素。这是一项回顾性的横断面设计,分析了 2018 年 6 月至 2022 年 5 月期间从塔马利地区公共卫生参考实验室收到的样本数据。使用 R 软件版本 4.2.0 分析数据。使用单变量和多变量二项逻辑回归分析来确定与多药耐药相关的因素。样本包括所有可能的标本类型。标本是为临床细菌学诊断收集的。总共获得了 1222 株分离株。导致感染的三种(3)主要细菌是:肺炎克雷伯菌(27%)、莫拉菌属(22%)、大肠杆菌(16%)。测试的抗生素耐药水平较高,约 41.60%分离的细菌菌株为多药耐药菌。在单变量(COR 1.96;95%CI 1.43-2.71;P 值<0.001)和多变量分析(AOR 1.78;95%CI 1.28-2.49;P 值<0.001)中,住院与多药耐药相关。需要进一步研究该地区抗生素耐药基因的分子流行病学,以有效控制多药耐药病原体的传播。此外,迫切需要努力提高卫生专业人员在感染预防和控制以及诊断和抗菌药物管理方面的能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e122/9772187/9b1f6b1077eb/41598_2022_26547_Fig1_HTML.jpg

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