坦桑尼亚姆万扎 COVID-19 大流行期间有下呼吸道感染症状和体征的成年患者中引起肺炎的细菌的病因和抗菌药敏感性模式:一项横断面研究。

IF 8.5 Q1 RESPIRATORY SYSTEM
Johannes Rukyaa, Martha F Mushi, Vitus Silago, Prisca Damiano, Katherine Keenan, Wilber Sabiiti, Matthew T G Holden, Jeremiah Seni, Stephen E Mshana
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引用次数: 0

摘要

背景:细菌性肺炎是全球发病和死亡的主要原因之一。在 2019 年科罗纳病毒病(COVID-19)大流行期间观察到的抗生素广泛滥用和过度使用可能改变了导致细菌性肺炎的病原体模式及其抗生素敏感性谱。本研究旨在确定在COVID-19大流行期间出现下呼吸道感染(LRTIs)症状和体征的成年患者中经培养确诊的细菌性肺炎的流行率,并描述其抗菌药敏感性谱:这项基于医院的横断面研究于 2021 年 7 月至 2022 年 7 月在坦桑尼亚姆万扎的一家地区转诊医院和两家地区医院进行。采用标准化问卷收集人口统计学和临床数据。痰液样本经常规培养处理后进行分离鉴定和抗生素药敏试验。使用 STATA 15.0 版本进行描述性数据分析:共有 286 名患者参与研究,中位年龄为 40 岁(IQR 29-60 岁)。超过一半的患者为女性(52.4%,n = 150)。细菌性肺炎的总发病率为 34.3%(98 人)。分离出的大多数细菌病原体是革兰氏阴性菌(GNB)(61.2%,60/98),其中以克雷伯菌属为主,占 38.8%(38/98),其次是化脓性链球菌(21.4%,21/98)。72/98(73.5%)的分离菌株中检测到耐多种药物(MDR)的细菌。对 GNB 耐药菌株的比例分别为:环丙沙星 60.0%(36/60)、阿莫西林 60%(36/60)、阿莫西林 60%(36/60)、三甲双氨-磺胺甲噁唑 68.3%(41/60)和头孢曲松 58.3%(35/60):结论:三分之一有 LRTI 症状和体征的患者经实验室确诊为细菌性肺炎,其中以革兰阴性耐药菌为主。这就要求在研究环境和发展中国家的其他环境中持续开展抗菌药物耐药性(AMR)监测和抗菌药物管理计划,以此作为应对 AMR 的重要策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Etiology and antimicrobial susceptibility patterns of bacteria causing pneumonia among adult patients with signs and symptoms of lower respiratory tract infections during the COVID-19 pandemic in Mwanza, Tanzania: a cross-sectional study.

Background: Bacterial pneumonia is among the leading causes of morbidity and mortality worldwide. The extensive misuse and overuse of antibiotics observed during the Corona Virus Disease 2019 (COVID-19) pandemic may have changed the patterns of pathogens causing bacterial pneumonia and their antibiotic susceptibility profiles. This study was designed to establish the prevalence of culture-confirmed bacterial pneumonia and describe their antimicrobial susceptibility profile in adult patients who presented with signs and symptoms of lower respiratory tract infections (LRTIs) during the COVID-19 pandemic.

Methodology: This hospital-based cross-sectional study was conducted from July 2021 to July 2022 at a zonal referral hospital and two district hospitals in Mwanza, Tanzania. Demographic and clinical data were collected using a standardized questionnaire. Sputum samples were processed by conventional culture followed by the identification of isolates and antibiotic susceptibility testing. Descriptive data analysis was performed using STATA version 15.0.

Results: A total of 286 patients with a median age of 40 (IQR 29-60) years were enrolled in the study. More than half of the patients enrolled were females (52.4%, n = 150). The overall prevalence of bacterial pneumonia was 34.3% (n = 98). The majority of the bacterial pathogens isolated were Gram-negative bacteria (GNB) (61.2%, 60/98), with a predominance of Klebsiella spp., 38.8% (38/98), followed by Streptococcus pyogenes (21.4%, 21/98). Multi drug resistant (MDR) bacteria were detected in 72/98 (73.5%) of the isolates. The proportions of GNB-resistant strains were 60.0% (36/60) for ciprofloxacin, 60% (36/60) for amoxicillin, 60% (36/60) for amoxicillin, 68.3% (41/60) for trimethoprim-sulfamethoxazole and 58.3% (35/60) for ceftriaxone.

Conclusion: One-third of the patients with signs and symptoms of LRTIs had laboratory-confirmed bacterial pneumonia with a predominance of Gram negative MDR bacteria. This calls for continuous antimicrobial resistance (AMR) surveillance and antimicrobial stewardship programs in the study setting and other settings in developing countries as important strategies for tackling AMR.

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Pneumonia
Pneumonia RESPIRATORY SYSTEM-
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1.50%
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11 weeks
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