Department of Medical Laboratory Science, College of health sciences, Debre Markos University, 269, Debre Markos, Ethiopia.
Department of Medical Laboratory sciences, College of health sciences, Injibara University, 40, Injibara, Ethiopia.
Ann Clin Microbiol Antimicrob. 2023 Jun 22;22(1):47. doi: 10.1186/s12941-023-00599-7.
Septicemia is potentially fatal infection caused by pathogenic bacteria infiltrating the bloodstream, resulting in morbidity and mortality among Ethiopian hospital patients. Multidrug resistance is a therapeutic challenge in this patient population. There is an insufficiency data among hospitals in Ethiopia. Hence, this study aimed to assess the phenotypic bacterial isolates, antimicrobial susceptibility pattern, and associated factors among septicemia suspected patients.
Prospective cross-sectional study was conducted among 214 septicemia suspected patients from February to June 2021 at Debre Markos Comprehensive Specialized hospital in northwest, Ethiopia. Blood samples were collected aseptically and processed to identify bacterial isolates by using different standard microbiological procedures. Antimicrobial susceptibility pattern was performed using the modified Kirby Bauer disc diffusion on Mueller Hinton agar. Epi-data V4.2 was used to enter data and SPSS V25 for analysis. The variables were assessed using a bivariate logistic regression model with a 95% confidence interval, and declared statistically significant; P-value was < 0.05.
The overall bacterial isolates was found 45/214 (21%) in this study. Gram-negative and positive bacteria were 25/45(55.6%), 20/45(44.4%) respectively. The most common bacterial isolates were Staphylococcus aureus12/45 (26.7%), Klebsiella pneumoniae 8/45(17.8%), Escherichia coli 6/45 (13.3%). Gram-negative bacteria showed susceptibility to amikacin (88%), meropenem, imipenem (76%) but, (92%) resistance to ampicillin, (85.7%) amoxicillin-clavulanic acid. S.aureus (91.7%) was resistance to Penicillin, (58.3%) cefoxitin and (75%) susceptible to ciprofloxacillin. S.pyogenes and S.agalactia were (100%) susceptible to Vancomacin. Multidrug resistance was found in 27/45(60%) of the bacterial isolates. The main predictors related to patients suspected of septicemia were prolonged hospitalization (AOR = 2.29, 95% CI: 1.18, 7.22), fever (AOR = 0.39, 95%CI: 0.18, 0.85) and length of hospital stay (AOR = 0.13, 95%CI: 0.02, 0.82).
Incidence of bacterial isolates among septicemia suspected patients were high. The majority of the bacterial isolates were multidrug-resistant. To prevent antimicrobial resistance, specific antibiotic utilization strategy should be applied.
败血症是一种潜在致命的感染，由致病性细菌渗透血液引起，导致埃塞俄比亚医院患者的发病率和死亡率。多药耐药性是该患者群体的治疗挑战。埃塞俄比亚医院的数据不足。因此，本研究旨在评估疑似败血症患者的表型细菌分离株、抗菌药物敏感性模式和相关因素。
2021 年 2 月至 6 月期间，在埃塞俄比亚西北部的德布雷马科斯综合专科医院，对 214 例疑似败血症患者进行了前瞻性横断面研究。无菌采集血样，并通过不同的标准微生物程序进行处理，以鉴定细菌分离株。使用改良 Kirby Bauer 纸片扩散法在 Mueller Hinton 琼脂上进行抗菌药物敏感性模式检测。使用 Epi-data V4.2 输入数据，使用 SPSS V25 进行分析。使用具有 95%置信区间的双变量逻辑回归模型评估变量，并宣布具有统计学意义；P 值<0.05。
本研究中，总细菌分离株为 45/214（21%）。革兰氏阴性菌和阳性菌分别为 25/45（55.6%）和 20/45（44.4%）。最常见的细菌分离株是金黄色葡萄球菌 12/45（26.7%）、肺炎克雷伯菌 8/45（17.8%）、大肠杆菌 6/45（13.3%）。革兰氏阴性菌对阿米卡星（88%）、美罗培南、亚胺培南（76%）敏感，但对氨苄西林（92%）、阿莫西林克拉维酸（85.7%）耐药。金黄色葡萄球菌对青霉素（91.7%）、头孢西丁（58.3%）耐药，对环丙沙星（75%）敏感。化脓链球菌和无乳链球菌对万古霉素（100%）敏感。45/45（60%）的细菌分离株存在多药耐药性。与疑似败血症患者相关的主要预测因素是住院时间延长（AOR=2.29，95%CI：1.18，7.22）、发热（AOR=0.39，95%CI：0.18，0.85）和住院时间延长（AOR=0.13，95%CI：0.02，0.82）。
疑似败血症患者的细菌分离株发生率较高。大多数细菌分离株为多药耐药性。为了防止抗菌药物耐药性，应采用特定的抗生素使用策略。
