三级医院不动杆菌和假单胞菌感染相关的抗生素敏感性模式和危险因素

J. B. Sherchan
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摘要

背景:由不动杆菌和铜绿假单胞菌引起的感染是当今世界关注的主要问题。在获得这种感染的患者中,抗生素耐药性和易感因素是全球和尼泊尔面临的一项重大挑战。目的:确定不动杆菌和铜绿假单胞菌的药敏模式及其易感因素。方法:对2019年12月至2020年11月的9705份临床样本进行分析性横断面研究。根据临床实验室标准协会的指南确定抗生素敏感性模式。患者信息是在知情同意后获取的。结果:分离不动杆菌和铜绿假单胞菌92株(0.95%);呼吸道标本53份(57.61%)。铜绿假单胞菌13株(20%)、不动杆菌18株(66.67%)耐多药。铜绿假单胞菌8株(12.31%)和不动杆菌13株(48.15%)仅对粘菌素敏感。22例(95.65%)住院时间较长,9例(13.04%)住院时间较短(p值<0.001)。16例糖尿病患者(94.12%)分离到耐多药细菌,而非糖尿病患者只有15例(20%)分离到耐多药细菌(p值<0.001)。65岁以下老年人31例(33.69%),65岁以下61例(66.31%)。老年患者中有17例(54.84%)存在MDR分离株,非老年患者中仅有14例(22.95%)存在MDR分离株(p值=0.0047)。结论:从不同样品中分离到不动杆菌和铜绿假单胞菌。为了有效治疗这些微生物引起的感染,需要进行详细的微生物学诊断和药敏试验,并确定诱发因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Antibiotic susceptibility pattern and risk factors associated with Acinetobacter and Pseudomonas infection at a tertiary care hospital
Background: Infection due to Acinetobacter spp. and Pseudomonas aeruginosa is a major worldwide concern these days. Antibiotic resistance and predisposing factors among the patients for acquiring such infection is a major challenge globally and in Nepal. Objectives: To determine antimicrobial susceptibility pattern of Acinetobacter spp. and Pseudomonas aeruginosa isolates along with predisposing factors. Methods: A total of 9,705 clinical samples were processed in this analytical cross-sectional study from December 2019 to November 2020. Antibiotic susceptibility pattern was determined following Clinical Laboratory Standard Institute guidelines. Patients’ information was obtained after informed consent. Results: Acinetobacter spp. and Pseudomonas aeruginosa isolates were 92 (0.95%). Fifty-three (57.61%) samples were respiratory samples. Thirteen (20%) Pseudomonas aeruginosa and 18 (66.67%) Acinetobacter spp. were multidrug-resistant (MDR). Eight (12.31%) Pseudomonas aeruginosa strains and 13 (48.15%) Acinetobacter spp. strains were sensitive only to Colistin.   Twenty-two (95.65%) prolonged hospital stayers had MDR bacteria compared to only nine (13.04%) non-prolonged hospital stayers (p-value <0.001). Sixteen (94.12%) of diabetic patients had MDR bacteria isolates in comparison to only 15 (20%) of non-diabetic patients (p-value <0.001). Thirty-one (33.69%) were elderly patients (age ?65 years) and 61 (66.31%) were of age less than 65 years old. Seventeen (54.84%) of elderly patients had MDR isolates whereas only 14 (22.95%) of patients who are not elderly had MDR isolates (p-value =0.0047). Conclusion: Acinetobacter spp. and Pseudomonas aeruginosa strain were isolated from various samples. For effective treatment of infection by such organisms detailed microbiological diagnosis and drug susceptibility testing is needed along with identification of predisposing factors.
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