儿童癌症患者抗生素耐药性的评估

A. Akhtar
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引用次数: 0

摘要

抗生素的发现彻底改变了医疗保健领域,因为许多以前无法治疗的致命感染现在已经变得非常可治愈。然而,临床医生对抗生素的高度依赖导致了抗生素的不合理使用,这导致了抗生素耐药性(AMR)形式的严重问题,微生物产生了中和抗生素抗微生物能力的现象。在癌症患者中,与其他患有感染性疾病的患者相比,AMR并不常见,但如果癌症患者在化疗期间遇到AMR问题,他们的癌症治疗就会变得非常具有挑战性。目的:了解儿童肿瘤患者抗生素治疗中抗菌素耐药性的发生率。材料和方法:在这项横断面研究中,300名儿科患者接受了至少一种抗生素的处方,并接受了至少一种抗生素的治疗。数据在监护人同意的情况下从巴基斯坦拉合尔儿童医院癌症病房和儿童健康研究所收集,采用非概率抽样技术(方便抽样),为期6个月。结果:研究结果显示,4 ~ 7岁儿童发生多种癌症,以淋巴细胞白血病(47%)为最常见的癌症。使用尿液、血液和粘膜拭子进行采样,但大多数样本是用于检测抗菌素耐药性发生的血液样本(29%)。观察到研究人群对革兰氏阴性菌比革兰氏阳性菌更敏感。革兰氏阴性菌的AMR发生率高于革兰氏阳性菌。在所收集的样品中,细菌对环丙沙星(23%)、阿米卡星(21%)、哌拉西林(24%)和头孢他啶(23%)敏感。考虑到癌症患者所使用抗生素的耐药情况,青霉素类抗生素和头孢他啶的AMR发生率较高。结论:AMR是儿科癌症患者感染治疗中遇到的一个严重问题,临床医生合理选择抗生素是预防AMR并使化疗获得最大治疗效果的重要问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of Antibiotic Resistance in Pediatric Patients Suffering from Cancer
Introduction: The discovery of antibiotics has revolutionized the field of healthcare since many lethal infections which were previously impossible to treat are now have become much curable. However, a high reliance of the clinicians on antibiotics have led to their irrational use which has given rise to a serious problem in the form of Antimicrobial Resistance (AMR) a phenomenon where the microbes develop the capacity to neutralize the antimicrobial capacity of the antibiotics. In cancer patient AMR is not so frequent as compared to other patients who suffer from infectious diseases but still if cancer patients during their chemotherapy encounter the issue of AMR their cancer treatment becomes highly challenging. Objective: To evaluate the prevalence of AMR in the cancer affected pediatric patients being treated with antibiotics. Materials and Methods: In this cross-sectional study 300 pediatric patients who received prescriptions with at least one antibiotic suffering from cancer and were treated with at least one antibiotic were included. The data was collected with the consent of their guardians from the cancer ward of The Children’s hospital and The Institute of Child Health, Lahore, Pakistan by utilizing non-probability sampling technique (convenient sampling) for the period of 6-months. Results: The study findings depicted that the children aged between 4 to 7 years got affected by various cancers and lymphoblastic leukemia (47%) was the most frequently occurring cancer. Urine, blood and mucosal swabs were used for sampling but majority of the samples were the blood (29%) samples that were used to detect the occurrence of AMR. It was observed that the study population was more susceptible to gram-negative bacteria than gram-positive bacteria. The incidence of AMR was higher in gram-negative bacteria than that of gram-positive bacteria. Among the collected samples the bacteria showed sensitivity for ciprofloxacin (23%), amikacin (21%), piperacillin (24%) and ceftazidime (23%). Considering the resistance patterns among the tested antibiotics that were prescribed to the cancer patients various penicillin antibiotics and ceftazidime showed a higher incidence of the AMR. Conclusion: The AMR is a serious problem that is encountered during the treatment of infections in the pediatric patients affected by cancer thus, the appropriate selection of antibiotics by the clinicians is a matter of serious concern so as to prevent AMR and to obtain maximum therapeutic outcomes of the chemotherapy.
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