阿联酋迪拜三级新生儿重症监护病房微生物谱模式及其敏感性模式:11年监测研究

Mahmoud Saleh ElHalik, J. Habibullah, Swarup Kumar Dash, Amany Abdelsamed Taha Elsayed
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引用次数: 0

摘要

新生儿败血症是对新生儿健康和福祉的全球性负担。它造成了太多的新生儿死亡率和发病率。然而,在过去的几十年里,合理使用抗菌药物治疗和积极的支持性管理已经改变了结果。了解当地流行的微生物和抗生素的敏感性模式有助于制定抗生素治疗方案。方法:本研究回顾性分析了从0 - 90天的怀疑有早发性或晚发性新生儿脓毒症的各种培养样本中分离出的流行微生物。2011年1月至2021年12月11年间,所有新生儿均入住拉蒂法妇幼医院新生儿重症监护病房(NICU)。采用描述性分析,结果以比例表示。数据分析使用Microsoft excel 2016和在线计算器。结果:从NICU共分离出4849株微生物培养阳性菌株。这些分离物包括从血液、脑脊液、气管内吸入物、喉咙/鼻咽、尿液、直肠、粪便、眼睛和浅表培养物中提取的样本。革兰氏阴性菌占56.3% (n= 2730)。革兰氏阳性菌占43.7% (n=2119)。最常见的分离菌种为肺炎克雷伯菌(15.7%)、凝固酶阴性葡萄球菌(con)(14.6%)、嗜麦芽窄养单胞菌(11.5%)和铜绿假单胞菌(11.1%)。在多重耐药菌(MDRO)中,广谱β -内酰胺酶(ESBL)肺炎克雷伯菌(n=208, 4.3%)和耐甲氧西林金黄色葡萄球菌(n=145, 3%)是优势菌株。在研究期间,革兰氏阳性和革兰氏阴性细菌均显著减少(2011年n=1055, 2021年n= 226)。讨论/结论:当务之急是实施严格的感染控制措施,合理使用广谱抗生素,持续监测耐多药耐药性的出现。定期跟踪微生物流行模式,使我们能够及时了解流行生物和mdro的出现情况。我们的新生儿重症监护病房抗菌政策根据监测数据进行了修改。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pattern of microbial profile and their susceptibility pattern in a tertiary level neonatal intensive care unit, Dubai, UAE: 11 years surveillance study
Introduction: Neonatal sepsis is a global burden on the health and wellbeing of the neonates. It mounts too many neonatal mortality and morbidity. However, rational use of antimicrobial therapy and aggressive supportive management has modified the outcome over the past few decades. A good knowledge of locally prevalent microbes and antibiotics sensitivity pattern help in formulating antibiotics regimen. Methodology: This study is a retrospective analysis of prevalent microorganisms isolated from various culture samples collected from neonates aged 0 - 90 days, suspected to have early or late onset neonatal sepsis. All the neonates were admitted to Neonatal intensive care unit (NICU) of Latifa Women and Children Hospital (LWCH) over an 11 year period (from January 2011 till December 2021). Descriptive analyses were used with results presented as proportions. Data were analyzed using Microsoft excel 2016 and online calculators. Results: A total of 4849 microbial culture positive isolates were identified from our NICU. These isolates included samples taken from, blood, cerebrospinal fluid, endotracheal aspirates, throat/nasopharynx, urine, rectal, stool, eyes and superficial cultures. Gram-negative bacteria were isolated in 56.3% (n= 2730). Gram positive bacteria accounted for 43.7% (n=2119) of isolates. Most common isolated bacterial species were Klebsiella pneumoniae (15.7%), Coagulase Negative Staphylococcus (CONS) (14.6%), Stenotrophomonas maltophilia (11.5%) and Pseudomonas aeruginosa (11.1%). Among the multidrug resistant organism (MDRO), Extended spectrum beta lactamase (ESBL) K. pneumoniae (n=208, 4.3%) and Methicillin resistant staphylococcus aureus (MRSA) (n=145, 3%) are the predominant strain. Over the study period, there is a significant reduction in both gram positive and gram negative bacterias (n=1055 in 2011 to 226 in 2021). Discussion/conclusion: The need of the hour is implementation of strict infection control measures and rationalized use of broad-spectrum antibiotics and continuous surveillance of emergence of MDROs. Regular tracking of the microbiological prevalence pattern kept us updated regarding prevailing organisms and emergence of MDROs. Our NICU antimicrobial policy modified in accordance with the surveillance data.
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