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坦桑尼亚达累斯萨拉姆一家三级医院耳鼻喉科就诊患者的耳部感染病因和抗菌药物敏感性模式:一项基于医院的横断面研究。

Aetiology of ear infection and antimicrobial susceptibility pattern among patients attending otorhinolaryngology clinic at a tertiary hospital in Dar es Salaam, Tanzania: a hospital-based cross-sectional study.

机构信息

Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of.

Department of Microbiology and Immunology, Mwanza University, Mwanza, Tanzania, United Republic of.

出版信息

BMJ Open. 2023 Apr 3;13(4):e068359. doi: 10.1136/bmjopen-2022-068359.

Abstract

OBJECTIVES

To determine the aetiological pathogens causing ear infections and their antimicrobial susceptibility patterns among patients with ear complaints at a tertiary hospital in Dar es Salaam.

DESIGN

Hospital-based cross-sectional study.

SETTINGS

Otorhinolaryngology clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania.

PARTICIPANTS

Patients presenting with signs and symptoms of ear infection.

MAIN OUTCOME MEASURE

Bacteria and fungi isolated from ear swab specimens of patients presenting with signs and symptoms of ear infection; and antimicrobial susceptibility patterns of isolated bacteria.

RESULTS

Two hundred and fifty-five participants were enrolled, with a median age of 31 years and an IQR of 15-49. Otitis externa was the predominant type of ear infection, accounting for 45.1%. We observed positive bacteria culture in 53.3% of study participants, in which 41% of isolates were obtained from patients with chronic suppurative otitis media. Moreover, (27.3%) and (24.2%) were the most frequently isolated bacteria, while spp, 12 (63.8%) and spp, 9 (36.2%) were the only isolated fungi. Furthermore, we report that 93% of isolated were resistant to amoxicillin/clavulanic acid, and 73% were resistant to ceftazidime. In addition, we detected 34.4% extended-spectrum beta-lactamase-producing (ESBL-PE) and 44.4% methicillin-resistance (MRSA). We also found that 22% of the bacteria isolates were resistant to ciprofloxacin, a primary topical antibiotic used in managing ear infections.

CONCLUSIONS

The findings from this study reveal that the leading aetiological agent of ear infection is bacteria. Furthermore, our findings show a significant proportion of ESBL-PE and MRSA-causing ear infections. Hence, detecting multidrug-resistant bacteria is crucial to improving ear infection management.

摘要

目的

确定在达累斯萨拉姆的一家三级医院就诊的耳部疾病患者的耳部感染病因病原体及其抗生素药敏模式。

设计

医院横断面研究。

设置

坦桑尼亚达累斯萨拉姆穆希比利国家医院耳鼻喉科诊所。

参与者

出现耳部感染症状和体征的患者。

主要观察指标

出现耳部感染症状和体征的患者的耳拭子标本中分离出的细菌和真菌;以及分离出的细菌的抗生素药敏模式。

结果

共纳入 255 名参与者,中位年龄为 31 岁,IQR 为 15-49。外耳炎是最常见的耳部感染类型,占 45.1%。我们观察到 53.3%的研究参与者的细菌培养呈阳性,其中 41%的分离株来自慢性化脓性中耳炎患者。此外, (27.3%)和 (24.2%)是最常分离出的细菌,而 spp、12 株(63.8%)和 spp、9 株(36.2%)是唯一分离出的真菌。此外,我们报告 93%的分离出的 对阿莫西林/克拉维酸耐药,73%的分离出的 对头孢他啶耐药。此外,我们检测到 34.4%产超广谱β-内酰胺酶的 (ESBL-PE)和 44.4%耐甲氧西林金黄色葡萄球菌(MRSA)。我们还发现,22%的细菌分离株对治疗耳部感染的主要局部抗生素环丙沙星耐药。

结论

本研究结果表明,耳部感染的主要病因是细菌。此外,我们的研究结果显示,相当比例的 ESBL-PE 和 MRSA 引起的耳部感染。因此,检测多药耐药菌对于改善耳部感染的管理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f28/10083798/87abdce537fa/bmjopen-2022-068359f01.jpg

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