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沙特阿拉伯利雅得一家长期护理医院男性患者中肺炎克雷伯菌感染的流行病学及抗生素耐药模式:一项回顾性研究

Epidemiology and Antibiotic Resistance Patterns of Klebsiella pneumoniae Infections Among Male Patients in a Long-Term Care Hospital in Riyadh, Saudi Arabia: A Retrospective Study.

作者信息

Alfaifi Badriah A, Alkhaldi Saleh A, Alanazi Majed D, Shuraim Wadi A, Aldossry Masoud A, Alzahrani Hanan S, Alhaitei Fatoom A

机构信息

Infection Control, Long Term Care Hospital, Riyadh, SAU.

Research Center, King Saud Medical City, Riyadh, SAU.

出版信息

Cureus. 2024 Oct 22;16(10):e72101. doi: 10.7759/cureus.72101. eCollection 2024 Oct.

Abstract

BACKGROUND

is an opportunistic pathogen commonly found in the normal flora of the gastrointestinal tract. While it typically remains benign, it can lead to severe healthcare-associated infections, particularly among immunocompromised individuals and those in long-term care settings. This study aimed to investigate the epidemiology and antibiotic resistance patterns of infections among male patients in a long-term care hospital.

METHODS

A retrospective cross-sectional study was conducted, analyzing microbial culture data from 29 male patients admitted to the male ward of a long-term care hospital in Riyadh, Saudi Arabia. The study included patients with confirmed positive cultures for . Data were collected regarding demographic information, culture sites, and antibiotic susceptibility test results. Statistical analysis was performed to identify significant associations between patient characteristics and resistance patterns, with a particular focus on the prevalence of carbapenem-resistant Enterobacterales (CRE) and the production of extended-spectrum beta-lactamases (ESBL).

RESULTS

Around 51.7% of the isolates were found to be resistant to carbapenems, while 24.1% were classified as producers of ESBL. Patients suffering from bedsores had a significantly higher prevalence of CRE infections at 37.9% compared to only 13.8% in patients without bedsores (p=0.034). The analysis also indicated that older patients (aged over 50 years) exhibited a higher prevalence of CRE infections (34.5%) compared to their younger counterparts (17.2%, p=0.069). Notably, resistance levels against antibiotics were high, with 75.9% of isolates resistant to cotrimoxazole, 65.5% to ciprofloxacin, and 62.1% to gentamicin. In contrast, imipenem and meropenem showed relatively higher susceptibility, with each antibiotic having a susceptibility rate of 34.5%.

CONCLUSION

There is a significant prevalence of multidrug-resistant infections in long-term care environments, particularly affecting older male patients and those with bedsores. These findings underscore the need for targeted infection control measures and enhanced antibiotic stewardship programs. Future research should include both genders to investigate epidemiological differences and broader resistance trends.

摘要

背景

是一种机会致病菌,常见于胃肠道正常菌群中。虽然它通常保持良性,但可导致严重的医疗保健相关感染,尤其是在免疫功能低下的个体和长期护理机构中的人群中。本研究旨在调查一家长期护理医院男性患者感染的流行病学和抗生素耐药模式。

方法

进行了一项回顾性横断面研究,分析了沙特阿拉伯利雅得一家长期护理医院男性病房收治的29名男性患者的微生物培养数据。该研究纳入了培养确诊为阳性的患者。收集了有关人口统计学信息、培养部位和抗生素敏感性试验结果的数据。进行统计分析以确定患者特征与耐药模式之间的显著关联,特别关注耐碳青霉烯类肠杆菌科细菌(CRE)的患病率和超广谱β-内酰胺酶(ESBL)的产生情况。

结果

约51.7%的分离株被发现对碳青霉烯类耐药,而24.1%被归类为ESBL生产者。患有褥疮的患者CRE感染患病率显著更高达37.9%,而无褥疮患者仅为13.8%(p=0.03)。分析还表明,老年患者(年龄超过50岁)CRE感染患病率(34.5%)高于年轻患者(17.2%,p=0.069)。值得注意的是,对抗生素的耐药水平很高,75.9%的分离株对复方新诺明耐药,65.5%对环丙沙星耐药,62.1%对庆大霉素耐药。相比之下,亚胺培南和美罗培南显示出相对较高的敏感性,每种抗生素的敏感率均为34.5%。

结论

长期护理环境中多重耐药感染的患病率很高,尤其影响老年男性患者和患有褥疮的患者。这些发现强调了针对性感染控制措施和加强抗生素管理计划的必要性。未来的研究应纳入两性以调查流行病学差异和更广泛的耐药趋势。

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