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COVID-19患者与非COVID-19患者之间细菌感染在不同分离株及其抗生素敏感性模式方面的比较研究。

A Comparative Study of Bacterial Infections Between COVID-19 and Non-COVID-19 Patients With Respect to Different Isolates and Their Antibiotic Sensitivity Pattern.

作者信息

Arun Nitali, Saurabh Kumar, Muni Sweta, Kumari Namrata, Dev Anand

机构信息

Microbiology, Indira Gandhi Institute of Medical Sciences, Patna, IND.

Emergency Medicine, Indira Gandhi Institute of Medical Sciences, Patna, IND.

出版信息

Cureus. 2023 Jun 13;15(6):e40387. doi: 10.7759/cureus.40387. eCollection 2023 Jun.

Abstract

Background Following the pandemic caused by SARS-CoV-2, the emergence of and following the pandemic has required major modifications to healthcare systems and frameworks. Antimicrobials have more than a few potential roles in managing COVID-19. Experimental cures for the treatment of SARS-CoV-2 are being explored. The availability of limited data suggests that nosocomial infections are associated with a higher risk of death and severity of COVID-19. To fill this knowledge gap, we conducted a study to assess the spectrum of bacteriological isolates in different samples from COVID-19 patients. Our study aimed to evaluate the antibiotic resistance pattern of these bacterial isolates and compare the spectrum of bacteriological isolates in different samples and their antibiotic sensitivity pattern between COVID-19 and non-COVID-19 patients. Methodology An observational cross-sectional, partly retrospective, and partly prospective study was carried out in the bacteriology section of the Department of Microbiology, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, for a total duration of six months from February 2021 to July 2021. The profile of pathogens isolated from 105 clinical samples from COVID-19 patients was studied. To detect COVID-19, RT-PCR was performed. All clinical specimens (urine, blood, pus, respiratory sample, etc.) were processed and cultured on different media to support the growth of the bacteria as per our standard operating procedures (SOP) for bacteriology samples. Antimicrobial susceptibility testing was carried out based on the Clinical and Laboratory Standards Institute. Results A total of 105 clinical samples were received in the bacteriology section of the Department of Microbiology, IGIMS, Patna, Bihar, from admitted COVID-19 patients. The mean age of study participants was 51.57 ± 14.76 years, and males (66.7%, 70/105) were more than females (33.3%, 35/105). The majority of the patients were 91 out of 105 (86.67%) from the ward and 14 from the ICU (13.33%). Of the total samples tested, 62 (59%) were urine samples, 26 (24.8%) were respiratory specimens, 13 (12.4%) were pus samples, 3 (2.9%) were body fluids, and 1 (1%) were tissue samples. Among the total pathogen isolates (n=57) obtained from patients with SARS-CoV-2 admitted to the ward and ICU, 56.14% (32) were gram-negative, 26.31% (15) were , and 17.54% (10) were gram-positive pathogens. The most isolated pathogen was (39.02%, 16/41) followed by (29.26%, 12/41), (7.31%, 3/41), and (2.43%, 1/41). spp. as gram-positive bacteria were isolated in 21.95% (9/41) of patients. Among the gram-negative bacteria (), the highest resistance was seen in ampicillin (100%,29/29). For non-, the highest resistance was seen in ceftriaxone (66.66%,2/3). spp. showed maximum ciprofloxacin, and gentamicin (high level) resistance was 100% (9/9). Conclusion Secondary infections with resistant pathogens in COVID-19 patients highlight the importance of antimicrobial management programs focused on the optimal selection of empirical treatments based on culture reports.

摘要

背景 在严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引发的大流行之后,大流行期间及之后的情况要求对医疗保健系统和框架进行重大调整。抗菌药物在管理2019冠状病毒病(COVID-19)方面具有多种潜在作用。目前正在探索治疗SARS-CoV-2的实验性疗法。有限的数据表明,医院感染与COVID-19患者更高的死亡风险和严重程度相关。为填补这一知识空白,我们开展了一项研究,以评估COVID-19患者不同样本中的细菌分离谱。我们的研究旨在评估这些细菌分离株的抗生素耐药模式,并比较不同样本中的细菌分离谱以及COVID-19患者与非COVID-19患者之间的抗生素敏感性模式。

方法 在比哈尔邦巴特那英迪拉·甘地医学科学研究所(IGIMS)微生物学系细菌学部门进行了一项观察性横断面研究,该研究部分为回顾性,部分为前瞻性,从2021年2月至2021年7月,为期六个月。研究了从105份COVID-19患者临床样本中分离出的病原体情况。采用逆转录聚合酶链反应(RT-PCR)检测COVID-19。所有临床标本(尿液、血液、脓液、呼吸道样本等)均按照我们的细菌学样本标准操作程序(SOP)进行处理,并在不同培养基上培养,以支持细菌生长。根据临床和实验室标准协会的标准进行抗菌药物敏感性测试。

结果 在比哈尔邦巴特那IGIMS微生物学系细菌学部门共收到105份来自入院COVID-19患者的临床样本。研究参与者的平均年龄为51.57±14.76岁,男性(66.7%,70/105)多于女性(33.3%,35/105)。大多数患者(105例中的91例,86.67%)来自病房,14例(13.33%)来自重症监护病房(ICU)。在所有检测样本中,62份(59%)为尿液样本,26份(24.8%)为呼吸道标本,13份(12.4%)为脓液样本,3份(2.9%)为体液样本,1份(1%)为组织样本。在从病房和ICU收治的SARS-CoV-2患者中获得的所有病原体分离株(n = 57)中,56.14%(32株)为革兰氏阴性菌,26.31%(15株)为[此处原文缺失信息],17.54%(10株)为革兰氏阳性病原体。最常分离出的病原体是[此处原文缺失信息](39.02%,16/41),其次是[此处原文缺失信息](29.26%,12/41)、[此处原文缺失信息](7.31%,3/41)和[此处原文缺失信息](2.43%,1/41)。作为革兰氏阳性菌的[此处原文缺失信息]属在21.95%(9/41)的患者中被分离出。在革兰氏阴性菌([此处原文缺失信息])中,氨苄西林的耐药率最高(100%,29/29)。对于非[此处原文缺失信息],头孢曲松的耐药率最高(66.66%,2/3)。[此处原文缺失信息]属对环丙沙星的耐药率最高,庆大霉素(高水平)的耐药率为100%(9/9)。

结论 COVID-19患者中耐药病原体的继发感染凸显了抗菌管理计划的重要性,该计划侧重于根据培养报告优化经验性治疗的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c4a/10344732/80445a261a59/cureus-0015-00000040387-i01.jpg

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