Chaudhary Raina, Bhatta Sabita, Pant Chiranjibi, Phuyal Naveen, Shrestha Lochana
Department of Microbiology, Nepalese Army Institute of Health Sciences, Sanobharyang, Kathmandu, Nepal.
Department of Medicine, Nepalese Army Institute of Health Sciences, Sanobharyang, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2024 Sep;62(277):582-586. doi: 10.31729/jnma.8747. Epub 2024 Sep 30.
Antimicrobial resistance is global health problem, amongst major causes for mortality. It is one of the hinderance for achievement of Sustainable Goal 3 (Good health and well-being) of World Health Organization. Multidrug resistant gram negative bacteria are major threat to humanity especially patients admitted in intensive care unit. This is associated with to treatment failure and mortality of the patients in intensive care unit. Therefore, this study was conducted to find out the prevalence of multidrug resistant gram negative bacteria in intensive care unit of tertiary care center.
A descriptive cross-sectional study was conducted in the Department of Microbiology of a tertiary care hospital from February, 2020 to August, 2021 for 18 months after obtaining ethical approval from the Institutional Review Committee (Reference Number: 246). All the samples from Intensive Care Unit were processed following standard methodology. Only gram-negative bacteria isolated from samples were included in the study. Convenience sampling method was used. The point estimate was calculated at 95% Confidence Interval. Data was entered in Microsoft Excel 2016 and analysis was done using IBM SPSS Statistics version 16.0.
Out of 500 samples, 380 (76%) showed growth of gram negative bacteria. The prevalence multidrug resistance was 316 (83.15%). The multidrug resistant bacteria isolates were species 43 (100%), non fermenter 57 (95%) and 129 (87.16%). Multidrug resistant isolates were least resistant towards carbapenem group of antibiotics.
The prevalence of multidrug resistant gram negative bacteria was found to be similar to other studies. Susceptibility towards commonly used both oral and intravenous antibiotics was low.
抗菌药物耐药性是一个全球性的健康问题，是主要的死亡原因之一。它是实现世界卫生组织可持续发展目标3（良好健康与福祉）的障碍之一。多重耐药革兰氏阴性菌对人类尤其是重症监护病房的患者构成重大威胁。这与重症监护病房患者的治疗失败和死亡率相关。因此，本研究旨在查明三级医疗中心重症监护病房中多重耐药革兰氏阴性菌的流行情况。
在一家三级医院的微生物科进行了一项描述性横断面研究，时间为2020年2月至2021年8月，为期18个月，此前已获得机构审查委员会的伦理批准（参考编号：246）。重症监护病房的所有样本均按照标准方法进行处理。本研究仅纳入从样本中分离出的革兰氏阴性菌。采用便利抽样法。在95%置信区间计算点估计值。数据录入Microsoft Excel 2016，并使用IBM SPSS Statistics 16.0版本进行分析。
在500份样本中，380份（76%）显示革兰氏阴性菌生长。多重耐药的患病率为316份（83.15%）。多重耐药细菌分离株中，肠杆菌科细菌43份（100%），非发酵菌57份（95%），肺炎克雷伯菌129份（87.16%）。多重耐药分离株对碳青霉烯类抗生素的耐药性最低。
发现多重耐药革兰氏阴性菌的患病率与其他研究相似。对常用的口服和静脉用抗生素的敏感性较低。
