Kahal Fares, Helwani Ahmed, Torbey André, Alsaadi Aya, Mohsen Fatema, Al Bani Maher
Faculty of Medicine.
Department of Paediatrics, Faculty of Medicine, Syrian Private University, Damascus, Syria.
Ann Med Surg (Lond). 2023 Mar 9;85(3):418-423. doi: 10.1097/MS9.0000000000000267. eCollection 2023 Mar.
Antimicrobial resistance is the third top-ranking global causative of death. Ninety per cent of babies with sepsis who were admitted to the ICU in the Middle East had antibiotic-resistant bacteria. We aim to describe the epidemiology, culture findings, bacterial antibiotic resistance, as well as the outcomes of children who present with nosocomial or community-acquired infections.
A retrospective observational cohort study was conducted to analyze children with positive culture results presenting with nosocomial or community-acquired infections in Damascus Hospital, Damascus, Syria, which is considered one of the biggest hospitals in Syria.
In all, 116 patients with 177 positive culture results were included in the study. However, 54 (47%) were males, and 62 (53%) were females. Ages ranged between 3 h and 13 years. Cases of positive culture results peaked at the age or period of 0-11 months, that is 59(50%). The most prevalent bacteria were a (33%), (21%), (15%) and (12%). The most used antibiotics were ceftriaxone (70%), vancomycin (60%) and amikacin (25%). The highest bacterial antibiotic resistance occurred with third-generation cephalosporins, and the most antibiotic-resistant bacterium was . Nosocomial infections occurred in 51% of the patients. Death was the outcome of 16% of the patients.
The situation regarding bacterial resistance to antibiotics is critical, with the most notable examples of these resisted antibiotics being ceftriaxone, cefepime, cefotaxime, trimethoprim, gentamycin, levofloxacin and piperacillin with tazobactam, and there is no doubt that this is a major contributing factor to the high prevalence of nosocomial infections and death rates found in this study.
抗菌药物耐药性是全球第三大致死原因。在中东地区入住重症监护病房的败血症婴儿中,90%感染了耐药菌。我们旨在描述医院获得性感染或社区获得性感染儿童的流行病学、培养结果、细菌抗生素耐药性以及转归情况。
进行了一项回顾性观察队列研究,分析叙利亚大马士革市大马士革医院(该国最大的医院之一)培养结果呈阳性的医院获得性感染或社区获得性感染儿童。
该研究共纳入116例患者,获得177份阳性培养结果。其中,男性54例(47%),女性62例(53%)。年龄范围为3小时至13岁。阳性培养结果病例在0至11个月龄或时期达到峰值,为59例(50%)。最常见的细菌是……(原文此处细菌名称缺失)(33%)、……(原文此处细菌名称缺失)(21%)、……(原文此处细菌名称缺失)(15%)和……(原文此处细菌名称缺失)(12%)。最常用的抗生素是头孢曲松(70%)、万古霉素(60%)和阿米卡星(25%)。第三代头孢菌素的细菌抗生素耐药性最高,最耐药的细菌是……(原文此处细菌名称缺失)。51%的患者发生医院获得性感染。16%的患者死亡。
细菌对抗生素的耐药情况严峻,这些耐药抗生素最显著的例子是头孢曲松、头孢吡肟、头孢噻肟、甲氧苄啶、庆大霉素、左氧氟沙星以及哌拉西林他唑巴坦,毫无疑问,这是本研究中医院获得性感染高患病率和死亡率的一个主要促成因素。