Malonza I M, Omari M A, Bwayo J J, Mwatha A K, Mutere A N, Murage E M, Ndinya-Achola J O
Department of Medical Microbiology, College of Health Sciences, University of Nairobi.
East Afr Med J. 1997 Mar;74(3):166-70.
The purpose of the study was to determine the pattern and antimicrobial sensitivity on community acquired bacterial strains in Nairobi, Kenya. Clinical specimens collected from out-patient clinics at the Kenyatta National Hospital were cultured on appropriate media and identified according to Cowen and Steel's manual. The antimicrobial sensitivity was determined using comparative disc diffusion techniques. Between 1991 and 1995, there were a total of 1659 positive cultures comprising 30 different bacterial species. Out of the overall gram negative isolates (61.9%), E.coli and Klebsiella spp formed over 70%. Among the gram positive, Staphylococcus aureus, Enterococcus and coagulase negative staphylococcus spp constituting 41%, 26% and 18% respectively were the most common. Most organisms showed multiple resistance patterns to commonly used antimicrobials similar to hospital acquired infections. The gram negative isolates were resistant to cotrimoxazole, ampicillin, tetracyclines, chloramphenicol, and sulphamethoxazole. However, the sensitivity of these organisms to gentamicin and kanamycin was between 60 and 90%. Among the gram positive isolates, there was a high resistance to penicillin and tetracyclines (60-90%) while the resistance to lincomycin, minocycline and chloramphenicol was low (5-50%). All isolates were, however, highly sensitive to cephalosporins and fluoroquinolones. Beta-lactamase production among, E.coli, Klebsiella spp and Staphylococcus aureus was 48.9%, 76.7%, 76.1% respectively. Methicillin resistance for Staphylococcus aureus was 59.2%. Indiscriminate use of antibiotics in the community may have selected for resistant strains. This calls for urgent need to review policies on prescription practices.
该研究的目的是确定肯尼亚内罗毕社区获得性细菌菌株的模式及抗菌敏感性。从肯雅塔国家医院门诊收集的临床标本在合适的培养基上培养，并根据考恩和斯蒂尔手册进行鉴定。使用比较纸片扩散技术测定抗菌敏感性。1991年至1995年期间，共有1659份阳性培养物，包含30种不同的细菌种类。在所有革兰氏阴性菌分离株中（61.9%），大肠杆菌和克雷伯菌属占比超过70%。在革兰氏阳性菌中，金黄色葡萄球菌、肠球菌和凝固酶阴性葡萄球菌属分别占41%、26%和18%，最为常见。大多数微生物对常用抗菌药物呈现多重耐药模式，与医院获得性感染相似。革兰氏阴性菌分离株对复方新诺明、氨苄西林、四环素、氯霉素和磺胺甲恶唑耐药。然而，这些微生物对庆大霉素和卡那霉素的敏感性在60%至90%之间。在革兰氏阳性菌分离株中，对青霉素和四环素的耐药性较高（60% - 90%），而对林可霉素、米诺环素和氯霉素的耐药性较低（5% - 50%）。不过，所有分离株对头孢菌素和氟喹诺酮类药物高度敏感。大肠杆菌、克雷伯菌属和金黄色葡萄球菌中产β-内酰胺酶的比例分别为48.9%、76.7%、76.1%。金黄色葡萄球菌对甲氧西林的耐药率为59.2%。社区中抗生素的滥用可能导致了耐药菌株的产生。这迫切需要对处方行为政策进行审查。
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