Seijas-Pereda Laura, Rescalvo-Casas Carlos, Hernando-Gozalo Marcos, Angmorkie-Eshun Vida, Agyei Eunice, Adu-Gyamfi Vivian, Sarsah Isaac, Alfonso-Romero Maite, Cuadros-González Juan, Soliveri-de Carranza Juan, Pérez-Tanoira Ramón
Departamento de Biomedicina y Biotecnología, Facultad de Medicina, Universidad de Alcalá, 28805 Madrid, Spain.
Departamento de Microbiología Clínica, Hospital Universitario Príncipe de Asturias, 28805 Madrid, Spain.
Antibiotics (Basel). 2023 Aug 16;12(8):1321. doi: 10.3390/antibiotics12081321.
Low- and middle-income countries bear a disproportionate burden of antimicrobial resistance and often lack adequate surveillance due to a paucity of microbiological studies. In this 2022 study, our goal was to contribute to a more precise antimicrobial treatment by understanding the prevalence of resistance in a rural environment, promoting antibiotic stewardship, and raising awareness about antimicrobial resistance. We assessed the prevalence of Multidrug-Resistant (MDR) and Extensively Drug-Resistant (XDR) in clinical samples from 2905 patients being treated at Saint Dominic's Hospital, Akwatia, in the countryside of the Eastern Region, Ghana, in the year 2022. To this purpose, the samples were cultured on agar plates prepared in the laboratory using purified Oxoid™ Thermo Scientific™ agar (Thermo Fisher Scientific; Waltham, MA, USA). Cystine Lactose Electrolyte-Deficient (CLED) agar was used for urine samples, while blood agar, chocolate agar, and MacConkey agar were used for the rest of the specimens tested (HVS, blood, BFA, sputum). Antimicrobial susceptibility was determined on site using the disc diffusion method (Kirby-Bauer test). MDR bacteria accounted for more than half (53.7%) of all microorganisms tested for three or more antibiotics and 37.3% of these were XDR. Multivariate regression analysis was performed to identify risk factors associated with acquiring MDR/XDR bacteria. The results showed an increased likelihood of MDR acquisition linked to being male (OR 2.39, < 0.001 for MDR and OR 1.95, = 0.027 for XDR), higher age (OR 1.01, = 0.049 for MDR), non-sputum samples (OR 0.32, = 0.009 for MDR), and urine samples (OR 7.46, < 0.001 for XDR). These findings emphasize the urgency for surveillance and control of antimicrobial resistance; to this end, making accurate diagnostics, studying the microorganism in question, and conducting susceptibility testing is of the utmost importance.
低收入和中等收入国家承受着不成比例的抗菌药物耐药负担，并且由于微生物学研究匮乏，往往缺乏充分的监测。在这项2022年的研究中，我们的目标是通过了解农村环境中的耐药率、促进抗生素管理以及提高对抗菌药物耐药性的认识，为更精确的抗菌治疗做出贡献。我们评估了2022年在加纳东部地区农村的阿夸蒂亚圣多米尼克医院接受治疗的2905名患者临床样本中的多重耐药（MDR）和广泛耐药（XDR）情况。为此，样本在实验室使用纯化的Oxoid™ Thermo Scientific™琼脂（赛默飞世尔科技；美国马萨诸塞州沃尔瑟姆）制备的琼脂平板上培养。胱氨酸乳糖电解质缺乏（CLED）琼脂用于尿液样本，而血琼脂、巧克力琼脂和麦康凯琼脂用于其余检测标本（高渗盐水拭子、血液、支气管肺泡灌洗、痰液）。使用纸片扩散法（ Kirby - Bauer试验）在现场测定抗菌药物敏感性。对三种或更多种抗生素检测的所有微生物中，MDR细菌占一半以上（53.7%），其中37.3%为XDR。进行多变量回归分析以确定与获得MDR/XDR细菌相关的危险因素。结果显示，男性获得MDR的可能性增加（MDR的比值比为2.39，P < 0.001；XDR的比值比为1.95，P = 0.027），年龄较大（MDR的比值比为1.01，P = 0.049），非痰液样本（MDR的比值比为0.32，P = 0.009）以及尿液样本（XDR的比值比为7.46，P < 0.001）。这些发现强调了监测和控制抗菌药物耐药性的紧迫性；为此，进行准确诊断、研究相关微生物并进行药敏试验至关重要。
