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加纳一家教学医院的当地抗菌谱研究

Development of a local antibiogram for a teaching hospital in Ghana.

作者信息

Dodoo Cornelius C, Odoi Hayford, Mensah Adelaide, Asafo-Adjei Karikari, Ampomah Ruth, Obeng Lydia, Jato Jonathan, Hutton-Nyameaye Araba, Aku Thelma A, Somuah Samuel O, Sarkodie Emmanuel, Orman Emmanuel, Mfoafo Kwadwo A, Ben Inemesit O, Kpokiri Eneyi E, Abba Fatima, Jani Yogini H

机构信息

School of Pharmacy, University of Health and Allied Sciences, Ho, Ghana.

Laboratory Department, Ho Teaching Hospital, Ho, Ghana.

出版信息

JAC Antimicrob Resist. 2023 Mar 27;5(2):dlad024. doi: 10.1093/jacamr/dlad024. eCollection 2023 Apr.

Abstract

BACKGROUND

Antimicrobial resistance threatens adequate healthcare provision against infectious diseases. Antibiograms, combined with patient clinical history, enable clinicians and pharmacists to select the best empirical treatments prior to culture results.

OBJECTIVES

To develop a local antibiogram for the Ho Teaching Hospital.

METHODS

This was a retrospective cross-sectional study, using data collected on bacterial isolates from January-December 2021. Samples from urine, stool, sputum, blood, and cerebrospinal fluid (CSF) were considered as well as, aspirates and swabs from wound, ears and vagina of patients. Bacteria were cultured on both enrichment and selective media including blood agar supplemented with 5% sheep blood and MacConkey agar, and identified by both the VITEK 2 system and routine biochemical tests. Data on routine culture and sensitivity tests performed on bacterial isolates from patient samples were retrieved from the hospital's health information system. Data were then entered into and analysed using WHONET.

RESULTS

In all, 891 pathogenic microorganisms were isolated from 835 patients who had positive culture tests. Gram-negative isolates accounted for about 77% of the total bacterial species. (246), spp. (180), spp. (168), spp. (101) and spp. (78) were the five most isolated pathogens. Most of the bacterial isolates showed high resistance (>70%) to ampicillin, piperacillin, ceftazidime, ceftriaxone, cefotaxime, penicillin G, amoxicillin, amoxicillin/clavulanic acid, ticarcillin/clavulanic acid and trimethoprim/sulfamethoxazole.

CONCLUSIONS

The isolates from the various samples were not susceptible to most of the antibiotics used in the study. The study reveals the resistance patterns of and spp. to some antibiotics on the WHO 'Watch' and 'Reserve' lists. Using antibiograms as part of antimicrobial stewardship programmes would optimize antibiotic use and preserve their efficacy.

摘要

背景

抗菌药物耐药性威胁着针对传染病的充分医疗保健服务。抗菌谱结合患者临床病史,可使临床医生和药剂师在获得培养结果之前选择最佳的经验性治疗方案。

目的

为霍教学医院制定一份当地抗菌谱。

方法

这是一项回顾性横断面研究,使用2021年1月至12月收集的细菌分离株数据。考虑了来自尿液、粪便、痰液、血液和脑脊液(CSF)的样本,以及患者伤口、耳朵和阴道的吸出物和拭子。细菌在富集培养基和选择性培养基上培养,包括补充有5%羊血的血琼脂和麦康凯琼脂,并通过VITEK 2系统和常规生化试验进行鉴定。从医院的健康信息系统中检索对患者样本中的细菌分离株进行常规培养和药敏试验的数据。然后将数据输入WHONET并进行分析。

结果

总共从835例培养试验呈阳性的患者中分离出891种致病微生物。革兰氏阴性菌分离株约占细菌总数的77%。大肠埃希菌(246株)、肺炎克雷伯菌(180株)、金黄色葡萄球菌(168株)、铜绿假单胞菌(101株)和鲍曼不动杆菌(78株)是分离最多的五种病原体。大多数细菌分离株对氨苄西林、哌拉西林、头孢他啶、头孢曲松、头孢噻肟、青霉素G、阿莫西林、阿莫西林/克拉维酸、替卡西林/克拉维酸和甲氧苄啶/磺胺甲恶唑表现出高耐药性(>70%)。

结论

来自各种样本的分离株对研究中使用的大多数抗生素不敏感。该研究揭示了大肠埃希菌和肺炎克雷伯菌对世界卫生组织“观察”和“储备”清单上某些抗生素的耐药模式。将抗菌谱用作抗菌管理计划的一部分将优化抗生素的使用并保持其疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e85/10041059/1fb54e9a52f5/dlad024f1.jpg

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