Kiya Girum Tesfaye, Mekonnen Zeleke, Asefa Elsah Tegene, Gudina Esayas Kebede, Ahmed Hanan, Beyene Getenet, Mekonnen Mekidim, Abebe Gemeda
School of Medical Laboratory Science, Institute of Health, Jimma University, Jimma, Ethiopia.
Department of Internal Medicine, Institute of Health, Jimma University, Jimma, Ethiopia.
BMC Infect Dis. 2025 Aug 20;25(1):1046. doi: 10.1186/s12879-025-11474-5.
Sepsis is a pressing global public health issue, particularly among patients admitted to intensive care unit (ICU), and it is linked to a high incidence of morbidity and mortality. Current understanding of bacterial profiles, antibiotic resistance patterns, and the magnitude of Extended-Spectrum Beta-Lactamase (ESBL) and Carbapenemase (CP) producing isolates in critically ill patients is vital for implementing strong management approaches tailored to combat antibiotic resistance and improve patient outcomes.
A prospective cross-sectional study was carried out involving 149 patients admitted to ICU with a presumptive diagnosis of sepsis at Jimma University Medical Center (JUMC) from October 2023 to October 2024. A structured questionnaire was administered to collect baseline demographic and clinical characteristics of the patients. Blood samples were aseptically collected and analyzed using standard microbiological technique to identify bacterial isolates. The Kirby-Bauer disc diffusion method was employed to conduct the antimicrobial susceptibility test. The MASTDISCS Combi AmpC and ESBL detection discs D68 C, and Combi Carba plus disc system D73C were used to examine ESBL and CP production, respectively.
Bacterial pathogens were isolated from 33 patients, representing an isolation rate of 22.1% (95% CI: 16.2-29.6%). Gram-negative bacteria (GNB) accounted for the majority of the isolates, 25/33 (75.8%), with Escherichia coli, 6/25 (24%) being the predominant species. Administering antibiotics before sample collection was associated with a lower likelihood of culture positivity (AOR: 0.05, 95% CI: 0.01-0.38; p = 0.004). In contrast, prolonged stay in the ICU was positively associated with culture positivity (AOR: 1.13, 95% CI:1.02-1.24; p = 0.02). Gram-negative bacteria exhibited a particularly high resistance to third- and fourth-generation cephalosporins, ranging from 66.7 to 80%. ESBL and CP producers accounted for 11/25 (44%) and 12/25(48%) of GNB, respectively. Additionally, 80% of Staphylococcus aureus isolates were methicillin resistant. Overall, about a third of all isolates, 11/33 (33.3%) were multidrug resistant strains.
The study shows a significant burden of MDR pathogens among critically ill sepsis patients, characterized by high prevalence of ESBL, CP, and MRSA. These findings underscore the urgent need to strengthen antibiotic stewardship and infection prevention strategies to curb resistance in ICU environments.
Not applicable.
脓毒症是一个紧迫的全球公共卫生问题，在重症监护病房（ICU）的患者中尤为突出，且与高发病率和死亡率相关。目前对于重症患者的细菌谱、抗生素耐药模式以及产超广谱β-内酰胺酶（ESBL）和碳青霉烯酶（CP）菌株的规模的了解，对于实施针对性的强有力管理方法以对抗抗生素耐药性并改善患者预后至关重要。
于2023年10月至2024年10月在吉马大学医学中心（JUMC）对149例疑似脓毒症入住ICU的患者进行了一项前瞻性横断面研究。采用结构化问卷收集患者的基线人口统计学和临床特征。无菌采集血样并使用标准微生物技术进行分析以鉴定细菌分离株。采用 Kirby-Bauer 纸片扩散法进行药敏试验。分别使用MASTDISCS Combi AmpC和ESBL检测纸片D68 C以及Combi Carba plus纸片系统D73C检测ESBL和CP的产生情况。
从33例患者中分离出细菌病原体，分离率为22.1%（95%CI：16.2 - 29.6%）。革兰氏阴性菌（GNB）占分离株的大多数，为25/33（75.8%），其中大肠杆菌6/25（24%）为主要菌种。在采集样本前使用抗生素与培养阳性的可能性较低相关（调整后比值比：0.05，95%CI：0.01 - 0.38；p = 0.004）。相比之下，在ICU的长时间停留与培养阳性呈正相关（调整后比值比：1.13，95%CI：1.02 - 1.24；p = 0.02）。革兰氏阴性菌对第三代和第四代头孢菌素表现出特别高的耐药性，范围从66.7%至80%。产ESBL和CP的菌株分别占GNB的11/25（44%）和12/25（48%）。此外，80%的金黄色葡萄球菌分离株对甲氧西林耐药。总体而言，所有分离株中约三分之一，即11/33（33.3%）为多重耐药菌株。
该研究表明重症脓毒症患者中多重耐药病原体的负担较重，其特征为ESBL、CP和耐甲氧西林金黄色葡萄球菌（MRSA） 的高流行率。这些发现强调了迫切需要加强抗生素管理和感染预防策略以遏制ICU环境中的耐药性。
不适用。
