埃塞俄比亚东北部部分医院产超广谱β-内酰胺酶和碳青霉烯酶革兰氏阴性非发酵菌的出现：一项前瞻性横断面研究。
Emergence of Extended-Spectrum Beta-Lactamase and Carbapenemase Producing Gram Negative Non-Fermenters at Selected Hospitals of Northeast Ethiopia: A Prospective Cross-Sectional Study.
作者信息
Tadesse Selamyhun, Geteneh Alene, Hailu Tilahun
机构信息
Department of Medical Laboratory Science, College of Health Sciences, Woldia University, Woldia, Ethiopia.
School of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia.
出版信息
Infect Drug Resist. 2023 Jul 27;16:4891-4901. doi: 10.2147/IDR.S407151. eCollection 2023.
BACKGROUND
The emergence and spread of extended-spectrum β-lactamases (ESβLs) and carbapenemase (CP) producing gram negative non-fermenters are becoming a serious public health threat globally. Infections caused by these pathogens limit treatment options and contribute to the significant morbidity and mortality. Thus, to reduce their spread, early detection of these superbugs is very crucial. This study therefore aimed to assess the prevalence of ESβLs and CP producing gram negative non-fermenters at selected hospitals of North East Ethiopia.
METHODS
A cross-sectional study was conducted from January to June 2021. and were identified using standard bacteriological techniques. ESβL and CP production were detected by combined disk diffusion and modified carbapenem inhibitory methods, respectively. Data were collected via face-to-face interview and patient card review. Chi-squared and Fisher's exact tests were calculated and p-value < 0.05 was considered statistically significant.
RESULTS
A total of 384 patients participated in this study. Overall, 30 (7.8%) patients had positive culture for and . The prevalence of was 20 (5.2%) and that of was 10 (2.6%). From the overall isolates, 16 (53.3%) were ESβL and the proportion of carbapenemase production was 4 (13.3%). ESβL production was 8 (40%) in and 8 (80%) in isolates. ESβL production infections were significantly associated with hospitalization (p=0.004). Intravenous catheterization, hospitalization, and surgery had significant association with ESβL production (p<0.005). All isolates of and were MDR.
CONCLUSION
ESβL and carbapenemase production among and were high in the selected hospitals. The treatment of such resistant infectious agents should be guided by antimicrobial susceptibility test in a study setting. Thus, restricted and wise use of antibiotics is highly recommended to contain the spread of these superbugs. Hospitals should develop infection prevention guidelines to prevent the spread of resistant pathogens in hospitalized patients.
背景
产超广谱β-内酰胺酶（ESβLs）和碳青霉烯酶（CP）的革兰氏阴性非发酵菌的出现和传播正成为全球严重的公共卫生威胁。这些病原体引起的感染限制了治疗选择，并导致了显著的发病率和死亡率。因此，为了减少它们的传播，早期检测这些超级细菌至关重要。因此，本研究旨在评估埃塞俄比亚东北部选定医院中产ESβLs和CP的革兰氏阴性非发酵菌的流行情况。
方法
于2021年1月至6月进行了一项横断面研究。使用标准细菌学技术进行鉴定。分别通过复合纸片扩散法和改良碳青霉烯抑制法检测ESβL和CP的产生。通过面对面访谈和患者病历审查收集数据。计算卡方检验和Fisher精确检验，p值<0.05被认为具有统计学意义。
结果
共有384名患者参与了本研究。总体而言，30名（7.8%）患者的[具体细菌名称]和[具体细菌名称]培养呈阳性。[具体细菌名称]的流行率为20名（5.2%），[具体细菌名称]的流行率为10名（2.6%）。在所有分离株中，16株（53.3%）产ESβL，产碳青霉烯酶的比例为4株（13.3%）。[具体细菌名称]中产ESβL的比例为8株（40%），[具体细菌名称]分离株中产ESβL的比例为8株（80%）。产ESβL感染与住院显著相关（p=0.004）。静脉置管、住院和手术与产ESβL显著相关（p<0.005）。所有[具体细菌名称]和[具体细菌名称]分离株均为多重耐药。
结论
在选定医院中，[具体细菌名称]和[具体细菌名称]中产ESβL和碳青霉烯酶的情况较为严重。在研究环境中，此类耐药感染病原体的治疗应以药敏试验为指导。因此，强烈建议限制并合理使用抗生素以遏制这些超级细菌的传播。医院应制定感染预防指南，以防止耐药病原体在住院患者中传播。
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