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阿维森纳军事医院医院获得性肺炎的细菌学特征及抗生素耐药现状

Bacteriological Profile of Nosocomial Pneumonia and Current State of Antibiotic Resistance in the Military Hospital of Avicenne.

作者信息

Didi Mehdi, Khallikane Said, Qamouss Youssef, Arsalane Lamiae, Zouhair Said

机构信息

Anesthesiology and Reanimation, Military Hospital of Avicenne, Marrakech, MAR.

Microbiology, Military Hospital of Avicenne, Marrakech, MAR.

出版信息

Cureus. 2024 Aug 29;16(8):e68125. doi: 10.7759/cureus.68125. eCollection 2024 Aug.

Abstract

This retrospective study, conducted over five years, aimed to assess the bacteriological profile of nosocomial pneumonia, the antibiotic resistance of isolated bacteria, and changes in these parameters over time. The analysis reviewed 660 samples from the microbiology department at the Military Hospital of Avicenne in Marrakech, Morocco, covering the period from January 1, 2017, to December 31, 2021. Among these samples, 303 microorganisms were identified from 251 specimens, confirming diagnoses of nosocomial pneumonia. Microorganism identification and antibiograms were performed using the Phoenix100 automated system from Becton Dickinson. The results revealed that 73% of the isolated microorganisms were Gram-negative bacilli, with (29.4%) being the most common, followed by Enterobacteriaceae (28%), particularly (15.5%) and (10.9%). Gram-positive cocci made up 22.5% of isolates, with (15.2%) being the most prevalent, while yeasts were present in 3.6% of cases. A polymicrobial nature was observed in 19.12% of samples. strains showed high resistance to most antibiotics, with an imipenem resistance rate of 88.5%; colistin was the only effective agent against these strains. In contrast, exhibited broad sensitivity to antibiotics, with only an 11.1% resistance rate to ceftazidime and good sensitivity to imipenem (80%). Extended-spectrum beta-lactamase production was noted in 11.5% of Enterobacteriaceae, mainly . Methicillin-resistant prevalence was low at 11.6%, and all strains were vancomycin-sensitive. The study highlights the importance of prudent antibiotic use, enhanced hospital hygiene practices, and ongoing monitoring of bacterial resistance. These measures are vital for developing therapeutic strategies suited to local epidemiology and reducing infections caused by multidrug-resistant microorganisms.

摘要

这项为期五年的回顾性研究旨在评估医院获得性肺炎的细菌学特征、分离细菌的抗生素耐药性以及这些参数随时间的变化。该分析回顾了摩洛哥马拉喀什阿维森纳军事医院微生物科在2017年1月1日至2021年12月31日期间的660份样本。在这些样本中,从251份标本中鉴定出303种微生物,确诊为医院获得性肺炎。使用贝克顿·迪金森公司的Phoenix100自动化系统进行微生物鉴定和药敏试验。结果显示,73%的分离微生物为革兰氏阴性杆菌,其中(29.4%)最为常见,其次是肠杆菌科(28%),尤其是(15.5%)和(10.9%)。革兰氏阳性球菌占分离株的22.5%,其中(15.2%)最为普遍,而酵母菌在3.6%的病例中存在。19.1:2%的样本具有多种微生物特性。菌株对大多数抗生素表现出高度耐药性,亚胺培南耐药率为88.5%;黏菌素是对抗这些菌株的唯一有效药物。相比之下,对多种抗生素表现出广泛敏感性,对头孢他啶的耐药率仅为11.1%,对亚胺培南的敏感性良好(80%)。11.5%的肠杆菌科细菌产生超广谱β-内酰胺酶,主要是。耐甲氧西林金黄色葡萄球菌的患病率较低,为11.6%,所有金黄色葡萄球菌菌株对万古霉素敏感。该研究强调了谨慎使用抗生素、加强医院卫生措施以及持续监测细菌耐药性的重要性。这些措施对于制定适合当地流行病学的治疗策略和减少多重耐药微生物引起的感染至关重要。

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