2022年约旦Al-Karak政府医院抗生素耐药模式监测。

IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES
Amin A Aqel, Tala M Al-Matarneh, Tayf K Al-Tarawneh, Tahrir Alnawayseh, Mohammed Alsbou, Yasser Gaber
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引用次数: 0

摘要

背景/目的:抗微生物药物耐药性被认为是全球最重要的公共卫生挑战之一,其流行率正在上升。在约旦,特别是在Al-Karak省,缺乏足够的抗微生物药物耐药性数据,无法作出准确的评估。目前研究的主要目的是评估2022年临床标本的抗生素耐药趋势,并评估抗生素耐药模式。本研究采用了世卫组织抗生素分类为获取、观察和保留(AWaRe)的重点。结果:革兰氏阳性菌中,粪肠球菌对呋喃妥因的敏感性为100%,对万古霉素的敏感性为96%;翠绿链球菌对替柯planin的敏感性为100%;凝血酶阴性葡萄球菌对甲氧苄啶+磺胺甲恶唑的敏感性为63%,对克林霉素的敏感性为47%。革兰氏阴性菌中,大肠埃希菌和肺炎克雷伯菌对磷霉素(大肠埃希菌:95%,肺炎克雷伯菌:80%)和阿米卡星(大肠埃希菌:93%,肺炎克雷伯菌:81%)敏感性较高。对甲氧苄氨嘧啶+磺胺甲恶唑(大肠杆菌:47%,肺炎克雷伯菌:53%)和呋喃妥因(肺炎克雷伯菌:30%)的耐药性显著。XDR菌株以铜绿假单胞菌最多(15%),其次为肺炎克雷伯菌(11%)和大肠杆菌(4%),PDR菌株以铜绿假单胞菌(6%)、肺炎克雷伯菌(3%)和大肠杆菌(0.6%)最多。4%的con和3%的S. viridans (α)存在XDR, 1%的金黄色葡萄球菌同时存在XDR和PDR。方法:对2022年1 - 12月在约旦Al Karak某医院采集的1187株分离菌进行横断面回顾性细菌种类及药敏研究。结论:在关键病原体中,特别是铜绿假单胞菌和肺炎克雷伯菌中XDR和PDR菌株的显著流行,强调了Al-Karak政府医院需要强有力的抗菌药物管理计划(ASP)和感染控制措施。一些可及组抗生素(如阿米卡星和呋喃妥因)的高敏感性支持在经验性治疗中优先考虑它们,而观察和保留抗生素的耐药性的出现突出了合理使用的必要性。这些发现对于调整当地策略以降低耐药菌株的传播和改善临床结果具有重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Monitoring of Antibiotic Resistance Patterns Within Al-Karak Governmental Hospital, Jordan, in 2022.

Background/Objectives: Antimicrobial resistance is considered one of the foremost global public health challenges, and its prevalence is increasing. In Jordan, particularly in Al-Karak Governorate, there is a lack of sufficient data on antimicrobial resistance to make accurate assessments. The main aim of the current study was to evaluate antibiotic resistance trends in clinical specimens from 2022 and assess antibiotic resistance patterns. The emphasis on the WHO antibiotic classification as Access, Watch, and Reserved (AWaRe) was adopted in the current study. Results: Among Gram-positive bacteria, Enterococcus faecalis exhibited 100% susceptibility to nitrofurantoin and 96% to vancomycin, Streptococcus viridans exhibited 100% susceptibility to teicoplanin, while CoNS (coagulase-negative Staphylococci) showed moderate resistance to Trimethoprim + Sulfamethoxazole (63%) and clindamycin (47%). Among Gram-negative bacteria, Escherichia coli and Klebsiella pneumoniae displayed high susceptibility to fosfomycin (E. coli: 95%, K. pneumoniae: 80%) and amikacin (E. coli: 93%, K. pneumoniae: 81%). Resistance was notable for trimethoprim + sulfamethoxazole (E. coli: 47%, K. pneumoniae: 53%) and nitrofurantoin (K. pneumoniae: 30%). Pseudomonas aeruginosa exhibited the highest proportion of XDR strains (15%), followed by K. pneumoniae (11%) and E. coli (4%), while PDR strains were found in P. aeruginosa (6%), K. pneumoniae (3%), and E. coli (0.6%). XDR was observed in 4% of CoNS and 3% of S. viridans (α), with Staphylococcus aureus exhibiting both XDR and PDR at 1%. Methods: A cross-sectional retrospective study of bacterial species and their antimicrobial susceptibility was carried out at a hospital in Al Karak, Jordan, from January to December of 2022, the study included 1187 isolates from all locations in Al-Karak Governmental Hospital. Conclusions: The significant prevalence of XDR and PDR strains in key pathogens, particularly P. aeruginosa and K. pneumoniae, underscores the need for a robust Antimicrobial Stewardship Program (ASP) and infection control measures at Al-Karak Governmental Hospital. High susceptibility in several Access group antibiotics (e.g., amikacin and nitrofurantoin) supports their prioritization in empirical therapy, while the emergence of resistance in Watch and Reserved antibiotics highlights the necessity for rational use. These findings are very important for adjusting the local strategies to lower the spread of resistant strains and improve clinical outcomes.

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来源期刊
Antibiotics-Basel
Antibiotics-Basel Pharmacology, Toxicology and Pharmaceutics-General Pharmacology, Toxicology and Pharmaceutics
CiteScore
7.30
自引率
14.60%
发文量
1547
审稿时长
11 weeks
期刊介绍: Antibiotics (ISSN 2079-6382) is an open access, peer reviewed journal on all aspects of antibiotics. Antibiotics is a multi-disciplinary journal encompassing the general fields of biochemistry, chemistry, genetics, microbiology and pharmacology. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. Therefore, there is no restriction on the length of papers.
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