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黎巴嫩革兰氏阳性病原体的流行情况及抗菌药物耐药性:监测与管理的必要性。

Prevalence and antimicrobial resistance of gram-positive pathogens in Lebanon: The need for surveillance and stewardship.

作者信息

Khachab Yara, Khoumassi Racha, Salem Sokhn Elie

机构信息

Laboratory Department, Lebanese Hospital Geitaoui-University Medical Center, Beirut, Lebanon.

Department of Laboratory and Transfusion Medicine, Lebanese University, Faculty of Medical Sciences, Beirut, Lebanon.

出版信息

New Microbes New Infect. 2025 Apr 19;65:101588. doi: 10.1016/j.nmni.2025.101588. eCollection 2025 Jun.

Abstract

BACKGROUND

Resistance in Gram-positive organisms, including methicillin-resistant (MRSA) and vancomycin-resistant (VRE), poses a significant healthcare challenge globally. However, data on these organisms in Lebanon remain limited. This retrospective study aimed to assess the prevalence and antimicrobial resistance patterns of (), coagulase-negative (CoNS), and spp. in clinical infections at the Lebanese Hospital Geitaoui - UMC from 2017 to 2023.

METHODS

A total of 2676 isolates were collected from urine, blood, respiratory specimens, and other infection sites. Bacterial identification was performed following WHO clinical bacteriology procedures, utilizing gram staining, catalase and coagulase tests, and biochemical assays. Antimicrobial susceptibility testing was conducted using the Kirby-Bauer disk diffusion method and minimum inhibitory concentration (MIC) analysis, interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Statistical analyses were performed using SPSS® version 24, with significance set at p < 0.05.

RESULTS

CoNS were the most prevalent (42.83 %), followed by spp. (28.81 %) and (28.36 %). Blood cultures had the highest isolation rates (29.04 %), predominantly CoNS (76.45 %). spp. dominated urinary tract infections (85.01 %), while was prevalent in wound/surgical site infections (59.23 %). Gender-specific trends showed CoNS and more in males, while spp. infections were more common in females.

CONCLUSION

This study provides valuable insights into the prevalence and resistance patterns of Gram-positive pathogens in a Lebanese hospital setting. The findings highlight the need for continuous surveillance and stringent antibiotic stewardship to combat antimicrobial resistance effectively.

摘要

背景

革兰氏阳性菌的耐药性,包括耐甲氧西林金黄色葡萄球菌(MRSA)和耐万古霉素肠球菌(VRE),在全球范围内对医疗保健构成了重大挑战。然而,黎巴嫩关于这些细菌的数据仍然有限。这项回顾性研究旨在评估2017年至2023年期间黎巴嫩盖陶伊医院 - 大学医学中心临床感染中金黄色葡萄球菌、凝固酶阴性葡萄球菌(CoNS)和肠球菌属的流行情况及抗菌耐药模式。

方法

共从尿液、血液、呼吸道标本和其他感染部位收集了2676株分离株。按照世界卫生组织临床细菌学程序进行细菌鉴定,采用革兰氏染色、过氧化氢酶和凝固酶试验以及生化分析。使用 Kirby - Bauer 纸片扩散法和最低抑菌浓度(MIC)分析进行抗菌药物敏感性测试,并根据临床和实验室标准协会(CLSI)指南进行解释。使用SPSS® 24版进行统计分析,显著性设定为p < 0.05。

结果

CoNS最为常见(42.83%),其次是金黄色葡萄球菌属(28.81%)和肠球菌属(28.36%)。血培养的分离率最高(29.04%),主要是CoNS(76.45%)。金黄色葡萄球菌属在尿路感染中占主导(85.01%),而肠球菌属在伤口/手术部位感染中较为普遍(59.23%)。性别特异性趋势显示,CoNS和肠球菌属在男性中更多见,而金黄色葡萄球菌属感染在女性中更常见。

结论

本研究为黎巴嫩医院环境中革兰氏阳性病原体的流行情况和耐药模式提供了有价值的见解。研究结果强调了持续监测和严格的抗生素管理以有效对抗抗菌药物耐药性的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d285/12051146/e71011f7d82d/ga1.jpg

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