Addis Zemen, Aschale Yibeltal, Fenta Abebe, Teffera Zigale Hibstu, Melkamu Abateneh, Tigab Abeba, Dilnessa Tebelay
Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Department of Medical Laboratory Sciences, College of Health Sciences, Debark University, Debark, Ethiopia.
Front Microbiol. 2025 Jun 13;16:1569242. doi: 10.3389/fmicb.2025.1569242. eCollection 2025.
is a major pathogenic bacterium associated with high morbidity and mortality worldwide. It exhibits resistance to multiple antibiotics, complicating treatment options. Despite its clinical significance, there is limited data on the prevalence of infections and the patterns of methicillin and inducible clindamycin resistance, particularly in Ethiopia. Understanding these resistance trends is essential for guiding appropriate therapy and improving patient outcomes.
To assess the prevalence of , methicillin and inducible clindamycin resistance patterns, and associated factors among patients with suspected bacterial infection at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia.
A hospital-based cross-sectional study was conducted among patients suspected of bacterial infections from 10 June 2023 to 28 February 2024. Blood, wound swab, cerebrospinal fluid, urine, eye swab, synovial fluid, ear swab, and pleural fluid were collected aseptically and inoculated onto appropriate media. was identified based on colony morphology, Gram staining, DNase test and biochemical tests. Antimicrobial susceptibility testing was performed on the isolates using the disk diffusion and the D-test techniques based on CLSI guideline. Data were entered into SPSS version 26 for analysis. Logistic regression was applied to assess the relationship between predictors and the outcome variable. A -value of ≤ 0.05 with a 95% CI was considered statistically significant.
Among the 339 study participants, 38 (11.2%) (95% CI: 8-15) tested positive for . Of these isolates, 14/38 (36.9%) were resistant to methicillin, 5/38 (13.1%) isolates were resistance to clindamycin by routine disk diffusion test whereas 10/38 (26.3%) isolates exhibited inducible clindamycin resistance using the D-test. The level of multidrug resistance was noted in 10/38 (26.3%) of the isolates. Significant factors associated with infection included illiteracy (AOR = 13.51; 95% CI: 3.56-21.90; = 0.018), having larger family size (AOR = 12.14; 95% CI: 2.38-20.43; = 0.024), and income level of less than 3,000 ETB (AOR = 6.20; 95% CI: 1.03-30.09; = 0.046).
The study revealed an 11.2% occurrence of among the study participants, with a substantial proportion exhibiting methicillin resistance (36.9%) and inducible clindamycin resistance (26.3%). These findings highlight a higher burden of clindamycin resistance in MRSA, underscoring the need for routine D-test screening to guide appropriate antibiotic therapy. Additionally, factors such illiteracy, low income and residing in rural areas were associated with infection. Targeted health education initiatives should be implemented, especially in rural areas and among populations with low literacy levels, to improve hygiene practices and reduce transmission.
是一种在全球范围内与高发病率和高死亡率相关的主要致病细菌。它对多种抗生素具有耐药性，使治疗选择变得复杂。尽管其具有临床意义，但关于感染的流行情况以及甲氧西林和诱导性克林霉素耐药模式的数据有限，尤其是在埃塞俄比亚。了解这些耐药趋势对于指导适当的治疗和改善患者预后至关重要。
评估埃塞俄比亚西北部德布雷马科斯综合专科医院疑似细菌感染患者中的感染率、甲氧西林和诱导性克林霉素耐药模式以及相关因素。
于2023年6月10日至2024年2月28日对疑似细菌感染的患者进行了一项基于医院的横断面研究。无菌采集血液、伤口拭子、脑脊液、尿液、眼拭子、滑液、耳拭子和胸水，并接种到合适的培养基上。根据菌落形态、革兰氏染色、DNA酶试验和生化试验进行鉴定。根据CLSI指南，使用纸片扩散法和D试验技术对分离株进行药敏试验。数据录入SPSS 26版进行分析。应用逻辑回归评估预测因素与结果变量之间的关系。P值≤0.05且95%置信区间被认为具有统计学意义。
在339名研究参与者中，38人（11.2%）（95%置信区间：8 - 15）检测呈阳性。在这些分离株中，14/38（36.9%）对甲氧西林耐药，5/38（13.1%）的分离株通过常规纸片扩散试验对克林霉素耐药，而10/38（26.3%）的分离株使用D试验显示诱导性克林霉素耐药。10/38（26.3%）的分离株存在多重耐药情况。与感染相关的显著因素包括文盲（比值比 = 13.51；95%置信区间：3.56 - 21.90；P = 0.018）、家庭规模较大（比值比 = 12.14；95%置信区间：2.38 - 20.43；P = 0.024）以及收入水平低于3000埃塞俄比亚比尔（比值比 = 6.20；95%置信区间：1.03 - 30.09；P = 0.046）。
该研究显示研究参与者中的感染率为11.2%，相当一部分表现出甲氧西林耐药（36.9%）和诱导性克林霉素耐药（26.3%）。这些发现突出了耐甲氧西林金黄色葡萄球菌中克林霉素耐药的更高负担，强调了进行常规D试验筛查以指导适当抗生素治疗的必要性。此外，文盲、低收入和居住在农村地区等因素与感染相关。应实施有针对性的健康教育举措，特别是在农村地区和低识字水平人群中，以改善卫生习惯并减少传播。
