埃塞俄比亚重症监护病房患者气管吸出物中多重耐药和产超广谱β-内酰胺酶革兰氏阴性菌的数量
Magnitude of multidrug-resistant and extended-spectrum β-lactamase-producing gram-negative bacteria from tracheal aspirates of intensive care unit patients in Ethiopia.
作者信息
Berhe Zenebe Gebreyohannes, Haile Shambel Araya, Hundie Gadissa Bedada, Wami Ashenafi Alemu, Addis Tesfa, Alehegn Elias, Abayneh Mahlet, Zergaw Shalom Tsegaye, Engida Natnael Dejene, Gebreyohanns Alganesh, Workneh Firehiwot, Hadgu Tsedale Woldu, Kahasay Yonas, Gorems Kasahun, Geremew Rozina Ambachew, Teshome Fitsum Girma, Adinew Tibebe, Gebrelibanos Daniel Kahase, Akalu Gizachew Taddesse, Solomon Semaria
机构信息
Department of Microbiology, Immunology and Parasitology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Department of Medical Laboratory Science, College of Health Science Addis Ababa University, Addis Ababa, Ethiopia.
出版信息
PLoS One. 2025 Jun 24;20(6):e0324199. doi: 10.1371/journal.pone.0324199. eCollection 2025.
BACKGROUND
Globally, multidrug-resistant (MDR) and extended-spectrum β-lactamase-producing (ESBL)Gram-negative bacterial pathogens are causing significant public health problems, particularly in intensive care units (ICUs) among patients on mechanical ventilation. The objective of the study was to identify Gram-negative bacterial pathogens from tracheal aspirates, determine the prevalence of MDR, and assess the prevalence of ESBL production among the isolates.
METHODS
A hospital-based cross-sectional study was conducted at St. Paul's Hospital Millennium Medical College (SPHMMC). A total of 181 ICU patients on mechanical ventilation from January to August of 2022 were included. Tracheal aspirates were collected using consecutive sampling techniques, and the samples were inoculated on chocolate, blood, and MacConkey agar plates. Conventional biochemical tests were used to identify Gram-negative bacteria, and antimicrobial susceptibility testing (AST) was carried out via the Kirby-Bauer disc diffusion method. The production of ESBL was confirmed by the combination disc method. The data were entered and analyzed using SPSS version 25 software.
RESULTS
In this study, 181 study participants were enrolled, with an age distribution ranging from 1 year to 81 years and a median and mode of 15 years and 1 year, respectively. The overall prevalence of Gram-negative bacteria was 65.2%. A total of 189 Gram-negative bacteria were found, of which 52 (44.1%) showed a single organism and 66 (55.9%) were multiple organisms. Of the 189 isolates, 69.8% were MDR, while 86.8% were ESBL producers. Acinetobacter species (50.8%) and Klebsiella pneumoniae (29.6%) were the predominant isolates, with MDRs of 78.1% and 71.4%, respectively, and ESBLs of 100% and 82.1%, respectively.
CONCLUSIONS
A high magnitude of MDR and ESBL was detected. In addition, there was high resistance to cephalosporin-class antibiotics, which is concerning. The MDRs Acinetobacter spp. and K. pneumoniae were the predominant isolates. Regular monitoring of antimicrobial resistance levels, implementing antimicrobial stewardship, and an effective infection control program should be strengthened.
背景
在全球范围内，耐多药（MDR）和产超广谱β-内酰胺酶（ESBL）的革兰氏阴性菌病原体正引发重大的公共卫生问题，尤其是在重症监护病房（ICU）中接受机械通气的患者中。本研究的目的是从气管吸出物中鉴定革兰氏阴性菌病原体，确定耐多药的患病率，并评估分离株中产ESBL的患病率。
方法
在圣保罗医院千禧医学院（SPHMMC）进行了一项基于医院的横断面研究。纳入了2022年1月至8月期间181例接受机械通气的ICU患者。采用连续抽样技术收集气管吸出物，并将样本接种在巧克力、血平板和麦康凯琼脂平板上。使用传统生化试验鉴定革兰氏阴性菌，并通过 Kirby-Bauer 纸片扩散法进行抗菌药物敏感性试验（AST）。通过组合纸片法确认ESBL的产生。使用SPSS 25版软件录入和分析数据。
结果
在本研究中，共纳入181名研究参与者，年龄分布为1岁至81岁，中位数和众数分别为15岁和1岁。革兰氏阴性菌的总体患病率为65.2%。共发现189株革兰氏阴性菌，其中52株（44.1%）为单一菌株，66株（55.9%）为多种菌株。在189株分离株中，69.8%为耐多药菌，而86.8%为产ESBL菌。不动杆菌属（50.8%）和肺炎克雷伯菌（29.6%）是主要的分离株，耐多药率分别为78.1%和71.4%，产ESBL率分别为100%和82.1%。
结论
检测到高水平的耐多药和产ESBL情况。此外，对头孢菌素类抗生素的耐药性较高，这令人担忧。耐多药的不动杆菌属和肺炎克雷伯菌是主要的分离株。应加强对抗菌药物耐药水平的定期监测、实施抗菌药物管理以及有效的感染控制计划。
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