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印度加尔各答一家三级护理医院重症监护病房成年及儿科患者中细菌病原体耐药模式的当前趋势

Current Trends in Antimicrobial Resistance Patterns in Bacterial Pathogens among Adult and Pediatric Patients in the Intensive Care Unit in a Tertiary Care Hospital in Kolkata, India.

作者信息

Chakraborty Mandira, Sardar Sayani, De Rituparna, Biswas Malabika, Mascellino Maria Teresa, Miele Maria Claudia, Biswas Silpak, Mitra Anita Nandi

机构信息

Department of Microbiology, Calcutta Medical College and Hospital, Kolkata 700073, India.

Department of Microbiology, School of Tropical Medicine, Kolkata 700073, India.

出版信息

Antibiotics (Basel). 2023 Feb 24;12(3):459. doi: 10.3390/antibiotics12030459.

Abstract

Nosocomial infections by multidrug-resistant (MDR) bacteria are among the main causes of morbidity and death in patients hospitalized in intensive care units (ICUs) worldwide. Antibiotic resistance has become a major concern for treating the patients with nosocomial infections. The aim of this study was to describe the antibiotic resistance patterns of pathogens causing infections in adult and pediatric patients in the ICUs of a tertiary care hospital in Kolkata, India. A cross-sectional, retrospective study was conducted from January 2022 to October 2022 on a total of 139 adult and 146 pediatric patients. Depending on clinical symptoms of the patients, samples were collected and subjected to antibiotic sensitivity testing. The culture and sensitivity pattern of clinical isolates from blood, urine, sputum, endotracheal tube (ET) aspirate, and central line catheter insertion site swabs were analyzed. A total of 695 and 556 specimens were obtained from adult and pediatric ICU, respectively. Culture positivity rate among adults and pediatric patients were 37% and 40%, respectively. The most commonly isolated organisms were Gram-negative Enterobacterales and non-fermenters. Most of the bacterial isolates showed very high resistance against multiple antibiotics. from adult and pediatricpatients were found to be resistant to second generation cephalosporins (95% and 96%, respectively), beta-lactams (95% and 63%, respectively), fluoroquinolones (95% and 81%, respectively), and cotrimoxazole (85% and 78%, respectively). spp. from adult patients were found to be resistant to aminoglycosides (75%), second generation cephalosporins (100%), beta-lactams (94%), fluoroquinolones (92%), carbapenems (88%), and cotrimoxazole (83%). spp., , and spp. werefound to be resistant to multiple antibiotics. spp. from ICUs showed more than 90% resistance against ampicillin and more than 75% resistance against fluoroquinolones. MDR bacterial infections are increasing in both adult and pediatric ICUs, leading to significant therapeutic challenges. A frequent study of antimicrobial resistance patterns is imperative for antibiotic stewardshipin combatting the deadly effect of the MDR bacteria in critically ill patients.

摘要

耐多药(MDR)细菌引起的医院感染是全球重症监护病房(ICU)住院患者发病和死亡的主要原因之一。抗生素耐药性已成为治疗医院感染患者的主要关注点。本研究的目的是描述印度加尔各答一家三级医院ICU中成年和儿科患者感染病原体的抗生素耐药模式。2022年1月至2022年10月对总共139名成年患者和146名儿科患者进行了一项横断面回顾性研究。根据患者的临床症状,采集样本并进行抗生素敏感性测试。分析了血液、尿液、痰液、气管内插管(ET)吸出物和中心静脉导管插入部位拭子的临床分离株的培养和敏感性模式。分别从成人和儿科ICU获得了695份和556份标本。成人和儿科患者的培养阳性率分别为37%和40%。最常分离出的微生物是革兰氏阴性肠杆菌科细菌和非发酵菌。大多数细菌分离株对多种抗生素表现出很高的耐药性。成年和儿科患者的分离株对第二代头孢菌素(分别为95%和96%)、β-内酰胺类(分别为95%和63%)、氟喹诺酮类(分别为95%和81%)和复方新诺明(分别为85%和78%)耐药。成年患者的肠杆菌科细菌对氨基糖苷类(75%)、第二代头孢菌素(100%)、β-内酰胺类(94%)、氟喹诺酮类(92%)、碳青霉烯类(88%)和复方新诺明(83%)耐药。肺炎克雷伯菌、鲍曼不动杆菌和铜绿假单胞菌对多种抗生素耐药。ICU分离的肺炎克雷伯菌对氨苄西林的耐药率超过90%,对氟喹诺酮类的耐药率超过75%。成年和儿科ICU中耐多药细菌感染均在增加,导致重大治疗挑战。为了对抗耐多药细菌对重症患者的致命影响,对抗菌药物耐药模式进行频繁研究对于抗生素管理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e33e/10044231/6865c9c4a3dd/antibiotics-12-00459-g001.jpg

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