Sensitivity Profile of Carbapenem-Resistant Enterobacteriaceae and Therapeutic Outcome in Children in Syria

Rama Jadeed, I. Anjak
{"title":"Sensitivity Profile of Carbapenem-Resistant Enterobacteriaceae and Therapeutic Outcome in Children in Syria","authors":"Rama Jadeed, I. Anjak","doi":"10.2991/ahsr.k.211012.013","DOIUrl":null,"url":null,"abstract":"Carbapenem-Resistant Enterobacteriaceae (CRE) threaten public health because the infections they cause carry a high mortality rate and limited treatment options. Few studies focus on these organisms in children compared to the number of the ones carried out on adults. Therefore, the importance of our research is to contribute to broadening our knowledge on the effects of these organisms in children. The objective of our research was to determine each of the following: the sensitivity profile of CRE, available treatment options for dealing with these bacteria, the therapeutic outcome, and the factors affecting this outcome. Our study design was a prospective, single-centre analytical cohort study. Samples were collected from the Children’s University Hospital in Damascus, which conatins 389 beds and 60 incubators. Disk diffusion was used to examine bacterial susceptibility; some samples were tested in BD Phoenix system. Our research examined antibiotics resistance rates, duration to treatment response, and mortality rate. The research sample included 277 samples, 125 of which were resistant to Carbapenem. High resistance to most of the available antibiotics characterized the Carbapenem Resistant Enterobacteriaceae strains. Colistin, Imipenem and Amikacin were the most used antibiotics in our study; one or two antibiotics were used in most cases. Moreover, the mortality rate was 42.4%, and most of the deaths were due to infection itself. The median duration of treatment response was 8.4 days, and the factors were associated with a statistically significant higher mortality rate (age less than one month, the use of certain antibiotics in treatment such as Piperacillin-Tazobactam, and association with respiratory tract infection). Regarding response to treatment, there was no significant difference between Resistant and Non-Resistant Carbapenem Enterobacteriaceae in terms of duration. Enterobacteriaceae resistance to Carbapenems caused a very high mortality rate. Our treatment options were limited; consequently, the introduction of novel antibiotics in our treatment options is required.","PeriodicalId":20538,"journal":{"name":"Proceedings of the 1st International Ninevah Conference on Medical Sciences (INCMS 2021)","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Proceedings of the 1st International Ninevah Conference on Medical Sciences (INCMS 2021)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2991/ahsr.k.211012.013","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1

Abstract

Carbapenem-Resistant Enterobacteriaceae (CRE) threaten public health because the infections they cause carry a high mortality rate and limited treatment options. Few studies focus on these organisms in children compared to the number of the ones carried out on adults. Therefore, the importance of our research is to contribute to broadening our knowledge on the effects of these organisms in children. The objective of our research was to determine each of the following: the sensitivity profile of CRE, available treatment options for dealing with these bacteria, the therapeutic outcome, and the factors affecting this outcome. Our study design was a prospective, single-centre analytical cohort study. Samples were collected from the Children’s University Hospital in Damascus, which conatins 389 beds and 60 incubators. Disk diffusion was used to examine bacterial susceptibility; some samples were tested in BD Phoenix system. Our research examined antibiotics resistance rates, duration to treatment response, and mortality rate. The research sample included 277 samples, 125 of which were resistant to Carbapenem. High resistance to most of the available antibiotics characterized the Carbapenem Resistant Enterobacteriaceae strains. Colistin, Imipenem and Amikacin were the most used antibiotics in our study; one or two antibiotics were used in most cases. Moreover, the mortality rate was 42.4%, and most of the deaths were due to infection itself. The median duration of treatment response was 8.4 days, and the factors were associated with a statistically significant higher mortality rate (age less than one month, the use of certain antibiotics in treatment such as Piperacillin-Tazobactam, and association with respiratory tract infection). Regarding response to treatment, there was no significant difference between Resistant and Non-Resistant Carbapenem Enterobacteriaceae in terms of duration. Enterobacteriaceae resistance to Carbapenems caused a very high mortality rate. Our treatment options were limited; consequently, the introduction of novel antibiotics in our treatment options is required.
叙利亚儿童耐碳青霉烯肠杆菌科的敏感性和治疗结果
碳青霉烯耐药肠杆菌科(CRE)威胁着公众健康,因为它们引起的感染具有高死亡率和有限的治疗选择。与对成人进行的研究数量相比,很少有研究关注儿童体内的这些微生物。因此,我们的研究的重要性在于有助于扩大我们对这些生物体对儿童的影响的认识。我们研究的目的是确定以下每一项:CRE的敏感性、处理这些细菌的可用治疗方案、治疗结果以及影响结果的因素。我们的研究设计是一项前瞻性、单中心分析队列研究。样本是从大马士革儿童大学医院收集的,该医院有389张床位和60个恒温箱。采用纸片扩散法检测细菌药敏;部分样品在BD Phoenix系统中进行了测试。我们的研究考察了抗生素耐药率、治疗反应持续时间和死亡率。研究样本共277份,其中碳青霉烯耐药125份。耐碳青霉烯肠杆菌科菌株对大多数现有抗生素具有高耐药性。粘菌素、亚胺培南和阿米卡星是本研究中使用最多的抗生素;大多数情况下使用一种或两种抗生素。此外,死亡率为42.4%,大多数死亡是由于感染本身。治疗反应的中位持续时间为8.4天,这些因素与具有统计学意义的较高死亡率相关(年龄小于一个月,在治疗中使用某些抗生素,如哌拉西林-他唑巴坦,以及与呼吸道感染相关)。至于对治疗的反应,耐药和非耐药碳青霉烯肠杆菌科在持续时间方面没有显著差异。肠杆菌科对碳青霉烯类的耐药性造成了非常高的死亡率。我们的治疗选择有限;因此,需要在我们的治疗方案中引入新型抗生素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信