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埃塞俄比亚西北部德布雷马科斯综合专科医院疑似无菌部位感染患者的细菌病因、抗菌药物敏感性模式及相关因素

Bacterial etiologies, antimicrobial susceptibility pattern and associated factors among patients suspected sterile body site infections at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia.

作者信息

Admas Dires, Demeke Gebreselassie, Adugna Adane, Esmael Ahmed

机构信息

Department of Medical Laboratory Science, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

出版信息

Front Med (Lausanne). 2024 May 7;11:1260841. doi: 10.3389/fmed.2024.1260841. eCollection 2024.

Abstract

BACKGROUND

Sterile body locations are usually associated with clinical urgency and life-threatening illnesses, and they are typically contaminated with diverse bacterial etiologies. If the bacteria acquire resistance to antimicrobial drugs, the public health crisis will only worsen. In developing countries, drug-resistant bacteria are common because of poor surveillance, diagnostic capacity, and control measures. Early diagnosis, and assessing the drug resistance and factors associated with infection are important to combat the drug resistance and treatment. This study aimed to assess the bacterial etiologies, antimicrobial susceptibility pattern, and possible associated factors among patients suspected of sterile body sites.

METHODS

A hospital-based cross-sectional study was conducted from June 2022 to August 2022 at Debre Markos Comprehensive Specialized Hospital in Amhara regional state, Ethiopia. One hundred seven study participants were selected using consecutive convenient sampling techniques. A structured questionnaire was used to collect socio-demographic and clinical data. Gram stain was done for a preliminary report and inoculated into blood agar, MacConkey agar, and chocolate agar and incubated aerobically and micro aerobically at 37°C for 24 h. Antimicrobial susceptibility testing was done by the modified Kirby Bauer's disk diffusion method. Data were analyzed using bivariate and multivariate logistic regression was used. A -value less than 0.05 is considered as statistically significant.

RESULTS

The overall magnitude of sterile body site infection among study participants was 7.5% (14/187). The majority of the isolates were Gram-negative bacteria with the predominant species accounting for 28.57% (4/14). Among isolates 78.57%(11/14) of them were multidrug-resistant isolates. Being inpatient, co-morbidity, and alcohol consumption were significantly associated with sterile body site infection.

CONCLUSION

In our study, Gram-negative bacteria were the predominant bacteria that infects sterile body fluid. The prevalence of multi-drug resistance bacteria isolates was significantly high. Therefore, before prescribing an empirical treatment, a medical professional should identify the bacterial etiology of sterile body fluids and the susceptibility of microbes to the drug.

摘要

背景

无菌身体部位通常与临床急症和危及生命的疾病相关,并且通常被多种细菌病原体污染。如果这些细菌获得对抗菌药物的耐药性,公共卫生危机将只会恶化。在发展中国家,由于监测、诊断能力和控制措施薄弱,耐药细菌很常见。早期诊断以及评估耐药性和与感染相关的因素对于对抗耐药性和治疗至关重要。本研究旨在评估疑似无菌身体部位患者的细菌病原体、抗菌药物敏感性模式以及可能的相关因素。

方法

2022年6月至2022年8月,在埃塞俄比亚阿姆哈拉州德布雷马科斯综合专科医院进行了一项基于医院的横断面研究。采用连续便利抽样技术选取了107名研究参与者。使用结构化问卷收集社会人口统计学和临床数据。进行革兰氏染色以获得初步报告,并接种到血琼脂、麦康凯琼脂和巧克力琼脂中,在37°C有氧和微需氧条件下培养24小时。采用改良的 Kirby Bauer 纸片扩散法进行抗菌药物敏感性试验。使用双变量分析,并采用多变量逻辑回归。P值小于0.05被认为具有统计学意义。

结果

研究参与者中无菌身体部位感染的总体发生率为7.5%(14/187)。大多数分离株为革兰氏阴性菌,主要菌种占28.57%(4/14)。在分离株中,78.57%(11/14)为多重耐药分离株。住院、合并症和饮酒与无菌身体部位感染显著相关。

结论

在我们的研究中,革兰氏阴性菌是感染无菌体液的主要细菌。多重耐药细菌分离株的患病率显著较高。因此,在开经验性治疗药物之前,医学专业人员应确定无菌体液的细菌病原体以及微生物对药物的敏感性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eec9/11106364/bd9aff3a726a/fmed-11-1260841-g001.jpg

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