ESKAPE 病原体:巴勒斯坦住院患者抗菌药耐药性模式、风险因素和结果的回顾性横断面研究。

IF 2.9 3区 医学 Q2 INFECTIOUS DISEASES
Infection and Drug Resistance Pub Date : 2024-09-03 eCollection Date: 2024-01-01 DOI:10.2147/IDR.S471645
Abdallah Damin Abukhalil, Sally Amer Barakat, Aseel Mansour, Ni'meh Al-Shami, Hani Naseef
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引用次数: 0

摘要

背景:ESKAPE病原体(粪肠球菌、金黄色葡萄球菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌和肠杆菌属)的抗菌药耐药性仍然是医院环境中的一大挑战:本研究旨在确定巴勒斯坦一家三级医疗医院住院患者的 ESKAPE 抗菌药耐药性模式以及与多重耐药菌株相关的因素:通过回顾 2021 年 11 月 1 日至 2022 年 11 月 30 日期间巴勒斯坦医疗中心患者的电子病历和实验室结果,开展了一项单中心回顾性横断面研究。研究对象包括入院 48 小时后感染 ESKAPE 病原体的 18 岁以上患者:本研究共纳入 231 名患者,其中 90.5%为 MDR 感染。共鉴定出 331 份 ESKAPE 病原体临床样本。鲍曼不动杆菌是最常见的 MDR 病原体(95.6%),对碳青霉烯耐药率超过 95%;其次是肺炎双球菌(83.8%),对广谱头孢菌素耐药率超过 90%;金黄色葡萄球菌(68.2%),对奥沙西林耐药率为 85%;粪大肠杆菌(40%),对万古霉素耐药率为 20%;铜绿假单胞菌(22.6%),对碳青霉烯耐药率为 30%。此外,在鲍曼不动杆菌、肺炎双球菌和产气荚膜杆菌中也发现了对可乐定的耐药性。MDR感染的风险因素包括年龄(p< 0.035)、科室(p< 0.001)和侵入性手术,如IUC(p< 0.001)、CVC(p< 0.000)和MV(p< 0.008)。确诊为 MDR 细菌感染的患者 30 天死亡率增加(p< 0.001):本研究结果表明,感染 ESKAPE 病原体的住院病人中存在令人担忧的 MDR,对一线抗菌药物产生耐药性,并对可乐定产生新的耐药性,从而最大限度地减少了治疗选择。医疗服务提供者和卫生部必须采取措施,制定预防抗菌药耐药性的政策,遵守感染控制指南,实施抗菌药管理计划,以预防和限制日益严重的健康危机,并支持研究以发现新的治疗方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
ESKAPE Pathogens: Antimicrobial Resistance Patterns, Risk Factors, and Outcomes a Retrospective Cross-Sectional Study of Hospitalized Patients in Palestine.

Background: Antimicrobial resistance to ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp). remains a major challenge in hospital settings.

Objective: This study aimed to determine the ESKAPE antimicrobial resistance patterns and associated factors with multi-drug resistance strains among hospitalized patients in a single tertiary care medical hospital in Palestine.

Methods: A single-center retrospective cross-sectional study was conducted by reviewing patients' electronic medical records and laboratory results from November 1, 2021, to November 30, 2022, at the Palestine Medical Complex in Palestine. The study included patients aged > 18 years who had been infected with ESKAPE pathogens 48 hours after hospital admission.

Results: This study included 231 patients, of whom 90.5% had MDR infections. In total, 331 clinical samples of ESKAPE pathogens were identified. A. baumannii was the most prevalent MDR pathogen (95.6%) with Carbapenem-resistant exceeding 95%, followed by K. pneumoniae (83.8%) with extended-spectrum cephalosporin resistance exceeding 90%, S. aureus (68.2) with 85% oxacillin-resistance, E. faecium (40%) with 20% vancomycin resistance, P. aeruginosa (22.6%) with 30% carbapenem resistance. Furthermore, emergent colistin resistance has been observed in A. baumannii, K. pneumoniae, and P. aerogenesis. Risk factors for MDR infection included age (p< 0.035), department (p< 0.001), and invasive procedures such as IUC (p< 0.001), CVC (p< 0.000), and MV (p< 0.008). Patients diagnosed with MDR bacteria had increased 30-day mortality (p< 0.001).

Conclusion: The findings of this study show alarming MDR among hospitalized patients infected with ESKAPE pathogens, with resistance to first-line antimicrobial agents and emerging resistance to colistin, minimizing treatment options. Healthcare providers and the Ministry of Health must take steps, adopt policies to prevent antimicrobial resistance, adhere to infection control guidelines, implement antimicrobial stewardship programs to prevent and limit the growing health crisis, and support research to discover new treatment options.

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来源期刊
Infection and Drug Resistance
Infection and Drug Resistance Medicine-Pharmacology (medical)
CiteScore
5.60
自引率
7.70%
发文量
826
审稿时长
16 weeks
期刊介绍: About Journal Editors Peer Reviewers Articles Article Publishing Charges Aims and Scope Call For Papers ISSN: 1178-6973 Editor-in-Chief: Professor Suresh Antony An international, peer-reviewed, open access journal that focuses on the optimal treatment of infection (bacterial, fungal and viral) and the development and institution of preventative strategies to minimize the development and spread of resistance.
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