在 COVID-19 大流行期间,儿科人群中出现广泛耐药伤寒的风险相当。

IF 2 Q2 MEDICINE, GENERAL & INTERNAL
Maria Khan, Maria Tasneem Khattak, Amina Gul, Muhammad Riaz, Fatima Tu Zahra
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引用次数: 0

摘要

目的:在巴基斯坦西北部,极端耐药(XDR)伤寒沙门氏菌分离株的数量正在增加,而那里的医疗保健设施已经因 2019 年冠状病毒病(COVID-19)问题而不堪重负。目前,我们描述了巴基斯坦开伯尔巴图克瓦省在 COVID-19 大流行期间首次大范围出现的 XDR 伤寒沙门氏菌疫情。这种伤寒沙门氏菌菌株对所有一线和二线药物甚至第三代头孢菌素都具有耐药性:从儿科血液样本中分离出的沙门氏菌对 2020 年 11 月至 12 月期间评估的各类抗生素具有高度耐药性。记录的人口统计学信息包括性别、年龄、地址和临床症状。白沙瓦市雷曼医学研究所的病理实验室从有症状的患者身上共采集了 562 份血液培养物。所有样本均按照法规要求进行处理,并在 BacT/ALERT 3D 培养箱中进行培养:在 562 份血液样本中,71 份包含伤寒沙门氏菌,其中 66 份(92.9%)和 5 份(7%)分别为耐多药(MDR)和 XDR。所有分离菌株对环丙沙星(100%)、氯霉素(100%)、头孢曲松(100%)、氨苄西林(100%)和复方新诺明(93%)完全耐药。阿奇霉素和碳青霉烯类药物对所有耐 MDR 或 XDR 伤寒沙门氏菌均有效。男性(76%)比女性(24%)更常见,15岁以下儿童(88%)的发病率大大高于成人(P = 0.0016):结论:高耐药性 XDR 伤寒沙门氏菌的出现令人担忧。由于缺乏可行的替代治疗方法,当前形势下有必要立即实施有效的预防措施,如伤寒疫苗接种、食品和水安全等。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A comparable risk of extensively drug-resistant typhoid fever in the pediatric cohort during the COVID-19 pandemic.

Objective: The number of extremely drug-resistant (XDR) Salmonella typhi isolates is growing in the northwest of Pakistan, where health-care facilities are already under strain due to the coronavirus disease 2019 (COVID-19) issue. In Khyber Pakhtunkhwa, Pakistan, we currently describe the first widespread appearance of an XDR Salmonella typhi epidemic during the COVID-19 pandemic. This strain of Salmonella typhi is resistant to all first- and second-line drugs and even the third-generation cephalosporin.

Methods: Salmonella species isolated from pediatric blood samples shown a high level of resistance to the various antibiotic classes evaluated between November and December 2020. Gender, age, address, and clinical symptoms were among the demographic information that was recorded. A total of 562 blood cultures from symptomatic patients have been collected by the Pathology Laboratory at a tertiary care institution of Rehman Medical Institute, Peshawar. All samples have been processed in accordance with regulatory requirements and incubated in BacT/ALERT 3D.

Results: Of the 562 blood samples, 71 included Salmonella typhi, of which 66 (92.9%) and 5 (7%) were multidrug resistant (MDR) and XDR, respectively. Ciprofloxacin (100%), chloramphenicol (100%), ceftriaxone (100%), ampicillin (100%), and cotrimoxazole (93%) were completely resistant to all isolates. Azithromycin and carbapenems were effective against every Salmonella typhi isolate that was MDR or XDR. Males (76%) were more commonly affected than females (24%), and the frequency was substantially higher in children under 15 years of age (88%) than in adults (P = 0.0016).

Conclusion: The emergence of XDR Salmonella typhi with a high level of resistance is in fact alarming. Due to the lack of viable treatment alternatives, the current situation necessitates the immediate implementation of efficient preventive measures, such as campaigns for typhoid vaccination and food and water safety.

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来源期刊
International Journal of Health Sciences-IJHS
International Journal of Health Sciences-IJHS MEDICINE, GENERAL & INTERNAL-
自引率
15.00%
发文量
49
审稿时长
8 weeks
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