肯尼亚西部糖尿病患者鼻咽带菌情况和肺炎链球菌对抗生素的敏感性

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2024-10-16 DOI:10.1016/j.diabres.2024.111892

Charity Wambui Kanyoro, Mercy Karoney, Henry Nyamogoba, Jemimah Kamano

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引用次数: 0

摘要

目的比较肯尼亚西部莫伊教学和转诊医院（Moi Teaching and Referral Hospital，MTRH）糖尿病患者和非糖尿病患者的鼻咽带菌情况和肺炎链球菌对抗生素的敏感性。方法在 MTRH 糖尿病和眼科诊所进行横断面研究。研究采用系统随机抽样法选取参与者。社会人口学数据和风险因素通过访谈人员发放的调查问卷收集。抽取血液样本测量随机血糖和 HbA1c 水平。鼻咽拭子在 24 小时内进行培养和抗生素敏感性检测。使用皮尔逊卡方检验、费雪精确检验、非配对 t 检验和威尔科克森检验评估相关性。总体而言，7.4%（95 % CI：4.4，11.4）的参与者携带肺炎链球菌。糖尿病患者的携带率（12.1% [95 % CI: 7.0, 19.0]）高于非糖尿病患者（2.48% [95 % CI: 1.0, 7.0]），差异具有统计学意义（p = 0.004）。糖尿病与较高的携带几率有关（调整后 OR 6.2，p = 0.012）。与年龄、性别、烹饪燃料、是否有 5 岁以下儿童或是否曾使用抗生素均无关联。在患有糖尿病的参与者中，肺炎链球菌的携带只与使用胰岛素有关。抗生素耐药性最高的是复方新诺明（94.44%），其次是阿莫西林（16.7%）和头孢呋辛（11.1%）。结论糖尿病患者鼻咽部肺炎链球菌携带率较高，对普通抗生素的耐药性较强，但大环内酯类抗生素仍然有效。

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Nasopharyngeal carriage and antibiotic susceptibility of Streptococcus pneumoniae among diabetes patients in western Kenya

Aims

To compare nasopharyngeal carriage and antibiotic susceptibility of Streptococcus pneumoniae among patients with and without diabetes at Moi Teaching and Referral Hospital (MTRH) in western Kenya.

Methods

A cross-sectional study was conducted at MTRH diabetes and eye clinics. Participants were selected using systematic random sampling. Sociodemographic data and risk factors were collected through interviewer-administered questionnaires. Blood samples were taken to measure random blood sugar and HbA1c levels. Nasopharyngeal swabs were cultured and tested for antibiotic susceptibility within 24 h. Data analysis was performed using STATA version 13. Associations were assessed using Pearson’s chi-square, Fisher’s exact test, unpaired t-test, and Wilcoxon test.

Results

A total of 124 participants with diabetes and 121 without diabetes were enrolled. Overall, 7.4 % (95 % CI: 4.4, 11.4) of participants carried S. pneumoniae. Carriage was higher in diabetes (12.1 % [95 % CI: 7.0, 19.0]) than non-diabetes participants (2.48 % [95 % CI: 1.0, 7.0]), with a statistically significant difference (p = 0.004). Diabetes was associated with higher odds of carriage (adjusted OR 6.2, p = 0.012). No association was found with age, sex, cooking fuel, presence of children under 5, or prior antibiotic use. Among participants with diabetes, carriage of Streptococcus Pneumoniae was only associated with insulin use. Antibiotic resistance was highest for cotrimoxazole (94.44 %), followed by amoxicillin (16.7 %) and cefuroxime (11.1 %). No resistance to macrolides was observed.

Conclusion

Nasopharyngeal carriage of S. pneumoniae is higher in patients with diabetes, with significant resistance to common antibiotics, though macrolides remain effective.

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.