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在一家三级护理医院就诊的扁桃体炎患者分离株中的细菌学特征及抗菌药物敏感性模式

Bacteriological Profiles and Antimicrobial Susceptibility Patterns Among Isolates in Tonsillitis Patients Attending a Tertiary Care Hospital.

作者信息

Shevale Vaishnavi B, Shinde Ravindra V, Patil Satish R

机构信息

Department of Microbiology, Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND.

出版信息

Cureus. 2024 Oct 25;16(10):e72403. doi: 10.7759/cureus.72403. eCollection 2024 Oct.

Abstract

BACKGROUND

Tonsillitis, primarily affecting children, is an inflammation of the pharyngeal tonsils caused by bacterial pathogens such as and or viral agents. It can be classified as acute, chronic, or recurrent based on episode duration and frequency. Effective treatment requires identifying causative pathogens and assessing antibiotic resistance patterns. This study aims to update the bacterial isolates and antibiotic resistance of tonsillitis pathogens to support empirical treatment strategies and inform infection control policies.

OBJECTIVE

This research was undertaken to assess the bacterial profiles and antibiotic susceptibility patterns of isolates obtained from tonsillitis patients.

MATERIALS AND METHODS

This research was undertaken in the Department of Microbiology at Krishna Institute of Medical Sciences, Krishna Hospital and Medical Research Centre, Karad, District Satara, during the period from November 2022 to November 2023. Specimen collection and processing were performed following standard guidelines. Tonsillar swabs were collected and processed for pathogen isolation and identification using Gram staining and various biochemical tests; the susceptibility to antimicrobials was tested using the Kirby-Bauer disc diffusion method on Mueller-Hinton agar in accordance with Clinical and Laboratory Standards Institute 2022 recommendations.

RESULT

Out of 105 clinically confirmed tonsillitis cases, 93 (88.57%) were culture-positive, with three cases presenting two isolates each, resulting in a total of 96 isolates, and 12 cases (11.43%) were culture-negative. A greater prevalence was noted among male patients (56 (60.21%)), with the highest occurrence observed in the 0-20-year age group (60 (64.51%)). Among the 96 isolates, 52 (54.16%) were Gram-negative and 44 (45.83%) were Gram-positive. The predominant isolate identified was  (39 (40.62%)), followed by (19 (19.79%)). Testing for antimicrobial susceptibility revealed that  was the most common isolate, showing sensitivity to chloramphenicol in 38 cases (97.43%), while  the second most common isolate showed the highest sensitivity to azithromycin in 17 cases (89.47%).

CONCLUSION

Among 105 clinically confirmed tonsillitis cases, 93 were culture-positive, resulting in 96 isolates. was the organism found most frequently, which showed maximum sensitivity to chloramphenicol, followed by , which is sensitive to azithromycin. Azithromycin, a macrolide, and chloramphenicol, a broad-spectrum antibiotic, both block bacterial protein synthesis via various mechanisms. This emphasizes the critical importance of analyzing bacterial profiles and resistance patterns to guide antimicrobial stewardship in tonsillitis management.

摘要

背景

扁桃体炎主要影响儿童,是由细菌病原体(如 和 )或病毒病原体引起的咽扁桃体炎症。根据发作持续时间和频率,可分为急性、慢性或复发性。有效的治疗需要识别致病病原体并评估抗生素耐药模式。本研究旨在更新扁桃体炎病原体的细菌分离株和抗生素耐药情况,以支持经验性治疗策略并为感染控制政策提供依据。

目的

本研究旨在评估从扁桃体炎患者分离出的细菌谱和抗生素敏感性模式。

材料与方法

本研究于2022年11月至2023年11月在萨塔拉区卡拉德市克里希纳医学科学研究所、克里希纳医院和医学研究中心的微生物学系进行。样本采集和处理按照标准指南进行。采集扁桃体拭子,通过革兰氏染色和各种生化试验进行病原体分离和鉴定;根据临床和实验室标准协会2022年的建议,采用 Kirby-Bauer 纸片扩散法在 Mueller-Hinton 琼脂上测试对抗菌药物的敏感性。

结果

在105例临床确诊的扁桃体炎病例中,93例(88.57%)培养阳性,其中3例各有两种分离株,共96株分离株,12例(11.43%)培养阴性。男性患者患病率更高(56例(60.21%)),0至20岁年龄组发病率最高(60例(64.51%))。在96株分离株中,52株(54.16%)为革兰氏阴性菌,44株(45.83%)为革兰氏阳性菌。鉴定出的主要分离株是 (39株(40.62%)),其次是 (19株(19.79%))。抗菌药物敏感性测试显示, 是最常见的分离株,38例(97.43%)对氯霉素敏感,而第二常见的分离株 对阿奇霉素敏感性最高,17例(89.47%)。

结论

在105例临床确诊的扁桃体炎病例中,93例培养阳性,共96株分离株。 是最常发现的病原体,对氯霉素敏感性最高,其次是 ,对阿奇霉素敏感。阿奇霉素是一种大环内酯类药物,氯霉素是一种广谱抗生素,两者均通过多种机制阻断细菌蛋白质合成。这强调了分析细菌谱和耐药模式对指导扁桃体炎管理中抗菌药物管理的至关重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0f6/11588323/27f509e7d3af/cureus-0016-00000072403-i01.jpg

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