赞比亚卢萨卡省和铜带省两家三级医疗机构的病人对铜绿假单胞菌的抗菌药耐药性概况及铜绿假单胞菌院内感染的相关风险因素。

IF 3.7 Q2 INFECTIOUS DISEASES
JAC-Antimicrobial Resistance Pub Date : 2024-09-16 eCollection Date: 2024-10-01 DOI:10.1093/jacamr/dlae139
Patrice Ntanda Mukomena, Martin Simuunza, Sody Munsaka, Geoffrey Kwenda, Flavien Bumbangi, Kaunda Yamba, Josephine Kabwe, Jean-Marie Kayembe, John Bwalya Muma
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引用次数: 0

摘要

背景:铜绿假单胞菌等病原体的抗菌药耐药性(AMR)是全球健康面临的十大威胁之一。然而,赞比亚的临床和分子数据很少。因此,我们评估了铜绿假单胞菌院内感染(NIs)的AMR概况:方法:在赞比亚两家大型三级医院开展了一项为期一年的医院横断面研究。对当前或之前接触过医院的患者进行了 NIs 筛查。本次研究的重点是确诊为铜绿假单胞菌 NIs 的患者。收集临床标本进行细菌培养,并对纯分离物进行 16S rRNA 基因片段的 PCR 扩增。医院感染或 NI 是指住院期间发生的感染,至少发生在入院后 48 小时。采用柯比鲍尔盘扩散法评估抗生素耐药性模式。采用χ2检验分析AMR与风险因素之间的关联:结果:共筛查了 841 名患者,并收集和分析了临床标本。其中 116 人(13.7%)被诊断为铜绿假单胞菌 NIs。参与者的年龄从 15 岁到 98 岁不等,平均年龄为 51 岁(SD ± 18)。导尿管相关尿路感染(57%)最为常见,其次是压疮(38.7%)。铜绿假单胞菌分离株主要对阿米卡星敏感,而阿米卡星对 FEP 的耐药性最高。我们观察到多重耐药性的发生率很高(73.6%)。AMR与碳青霉烯水解β-内酰胺酶基因blaOXA-51和手术护理有关:这项研究表明,对多种药物产生耐药性的铜绿假单胞菌普遍存在于赞比亚卢萨卡和恩多拉地区的医院中,甚至可能存在于全国范围内。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Antimicrobial resistance profiles of and associated risk factors for Pseudomonas aeruginosa nosocomial infection among patients at two tertiary healthcare facilities in Lusaka and Copperbelt Provinces, Zambia.

Background: Antimicrobial resistance (AMR) of pathogens such as Pseudomonas aeruginosa is among the top 10 threats to global health. However, clinical and molecular data are scarce in Zambia. We, therefore, evaluated the AMR profiles of P. aeruginosa nosocomial infections (NIs).

Methods: A year-long hospital-based cross-sectional study was conducted at two large tertiary-level hospitals in Zambia. Patients with current or previous hospital contact were screened for NIs. The current study focused on patients diagnosed with P. aeruginosa NIs. Clinical specimens were collected for bacteriological culture, and PCR amplification of 16S rRNA gene fragments was performed on pure isolates. Hospital or NIs were defined as infections that arise during hospitalization, occurring at least 48 h after admission. The Kirby-Bauer's disk diffusion method was used to evaluate antibiotic resistance patterns. The association between AMR and risk factors was analysed using the χ2 test.

Results: Eight hundred and forty-one patients were screened, and clinical specimens were collected and analysed. Of them, 116 (13.7%) were diagnosed with P. aeruginosa NIs. The participants' ages ranged from 15 to 98 years, with a mean of 51 (SD ± 18). Catheter-associated urinary tract infections (57%) were the most common, followed by pressure sores (38.7%). P. aeruginosa isolates were primarily susceptible to amikacin, which had the highest resistance to FEP. We observed a high prevalence of multidrug resistance (73.6%). The AMR was associated with carbapenem-hydrolysing β-lactamase gene blaOXA-51 and surgical care.

Conclusions: This study has demonstrated that multidrug-resistant P. aeruginosa is prevalent in hospitals in Zambia's Lusaka and Ndola districts and possibly countrywide.

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