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来自尼泊尔某地区两家三级医疗中心的产金属β-内酰胺酶铜绿假单胞菌分离株:一项描述性横断面研究。

Metallo-β-lactamase-producing Pseudomonas aeruginosa Isolates from Two Tertiary Care Centres in a District of Nepal: A Descriptive Cross-sectional Study.

作者信息

Shrestha Pushpa Man, Kattel Hari Prasad, Sharma Sangita, Bista Pratibha, Basnet Bhupendra Kumar, Ghimire Prakash, Rijal Komal Raj

机构信息

Tribhuvan University, Kirtipur, Kathmandu, Nepal.

Maharajgunj Medical Campus, Maharajgunj, Kathmandu, Nepal.

出版信息

JNMA J Nepal Med Assoc. 2024 Feb 29;62(271):202-206. doi: 10.31729/jnma.8498.

Abstract

INTRODUCTION

Pseudomonas aeruginosa isolates producing metallo-β-lactamase have caused nosocomial outbreaks, severe infections, and ineffective carbapenem therapy worldwide since 1991. Due to their prevalence, hospital infection control techniques are difficult. This study aimed to find out the prevalence of metallo-β-lactamase among P. aeruginosa isolates from two tertiary care hospitals in Kathmandu.

METHODS

A descriptive cross-sectional study was conducted at the Department of Microbiology and Department of Pathology of two tertiary care centres in Kathmandu from 7 December 2021 to 6 April 2023, after receiving ethical approval from the Ethical Review Board. Isolated strains were identified and tested for antibiotic susceptibility by modified Kirby-Bauer Methods. Metallo-β-lactamase presence was confirmed using an imipenem-imipenem/ ethylenediaminetetraacetic acid disc. A convenience sampling method was used. The point estimate was calculated at 95% Confidence Interval.

RESULTS

Among 255, Pseudomanas aeruginosa isolates, the distribution of metallo-β-lactamase-producing Pseudomanas aeruginosa was 103 (40.39%) (34.32-46.69 at 95% Confidence Interval). Multidrug resistance categories included multidrug resistance 74 (71.80%), extensively drug resistance 32 (31.10%), P. aeruginosa difficult-to-treat 16 (15.53%) and carbapenem-resistant P. aeruginosa was determined to be 82 (79.60%).

CONCLUSIONS

The study found a high prevalence of metallo-β-lactamase-producing Pseudomanas aeruginosa isolates, requiring early identification, infection control measures, and an all-inclusive antimicrobial therapy protocol to reduce their spread in medical settings.

摘要

引言

自1991年以来,产金属β-内酰胺酶的铜绿假单胞菌分离株已在全球范围内引发医院感染暴发、严重感染以及碳青霉烯治疗无效的情况。由于其广泛存在,医院感染控制技术面临困难。本研究旨在查明加德满都两家三级护理医院的铜绿假单胞菌分离株中产金属β-内酰胺酶的情况。

方法

在获得伦理审查委员会的伦理批准后,于2021年12月7日至2023年4月6日在加德满都两家三级护理中心的微生物学系和病理学系进行了一项描述性横断面研究。分离出的菌株通过改良的 Kirby-Bauer 方法进行鉴定和抗生素敏感性测试。使用亚胺培南-亚胺培南/乙二胺四乙酸纸片确认金属β-内酰胺酶的存在。采用便利抽样方法。在95%置信区间计算点估计值。

结果

在255株铜绿假单胞菌分离株中,产金属β-内酰胺酶的铜绿假单胞菌分布为103株(40.39%)(95%置信区间为34.32 - 46.69)。多重耐药类别包括多重耐药74株(71.80%)、广泛耐药32株(31.10%)、难治性铜绿假单胞菌16株(15.53%),耐碳青霉烯铜绿假单胞菌为82株(79.60%)。

结论

该研究发现产金属β-内酰胺酶的铜绿假单胞菌分离株患病率很高,需要早期识别、感染控制措施以及全面的抗菌治疗方案,以减少其在医疗机构中的传播。

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