2019冠状病毒病（covid -19）后时期某医院不同病房患者分离的耐多药细菌（MDRB）比较研究

The Microbe Pub Date : 2025-04-23 DOI:10.1016/j.microb.2025.100350

Abhishek Ojha, Dwight Figueiredo, Shabnum Khan

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引用次数: 0

摘要

抗菌药物耐药性（ABR）仍然是21世纪全球健康威胁之一。本研究旨在研究在2021年和2019冠状病毒病大流行期间（2022年和2023年）和2019冠状病毒病大流行后（2022年和2023年）从三级保健医院患者中分离出的耐多药细菌（MDRB）的流行和分布。研究共纳入100例患者，85% %成功出院（p值= <0.00001）， 5 %死亡（p值= <0.00001）。对患者样本进行微生物学和抗生素敏感性试验，以确定MDRB并评估其耐药概况。结果显示，与2021年（SE± 0.0380至± 0.0654）和2023年（SE± 0至± 0.1158）相比，2022年MDRB患病率增加（标准误差，SE，± 0.0351至± 0.0936）。在回收的样品中，γ变形菌属占主导地位。优势菌群为肺炎克雷伯菌（40 %）、大肠杆菌（28 %）、柠檬酸杆菌（19 %）、不动杆菌（7 %）和铜绿假单胞菌（6 %）。夏皮罗-威尔克检验的正态性范围为0.800 ~ 0.888 (p值= 0.081 ~ 0.351)，安德森-达林检验的正态性范围为0.343 ~ 0.511 （p值= 0.098 ~ 0.315）。这些MDRB的Shannon指数和Simpson指数分别为1.138 ~ 1.508和0.643 ~ 0.775，均匀度值为0.780 ~ 1.042，表明患者样本中微生物的多样性。药敏试验中，不动杆菌、柠檬酸杆菌、铜绿假单胞菌、大肠杆菌和肺炎克雷伯菌对23、15、14、13和11种抗生素的耐药率分别为100% %。此外，与先前的报告（de Souza et al., 2023， p值= 0.00001,Ruegsegger et al., 2022， p值= <0.0061）相比，本研究中MDRB，即肺炎克雷伯菌（40 %）、大肠杆菌（28 %）和柠檬酸杆菌（19 %）的百分比显著更高（p值= <0.00001）。总体而言，MDRB分布在不同年份（2021 - 2023年，在covid -19大流行期间和之后）和医疗条件下的患病率发生了变化。尽管抗生素耐药性高，但本研究的死亡率低于其他现有报告，这表明通过快速和量身定制的治疗可以有效恢复。这些结果表明，需要加强监测、监测和有针对性的治疗策略，以有效地管理ABR。

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Comparative study of multidrug-resistant bacteria (MDRB) isolated from patients in different wards of a hospital during the post-COVID-19 period

Antibacterial resistance (ABR) remains a global health threat in the 21^st century. This study aimed to examine the prevalence and distribution of multidrug-resistant bacteria (MDRB) isolated from patients in a tertiary care hospital during (2021) and post-COVID-19 (2022 and 2023) pandemic years. In the study, 100 patients were involved, with 85 % successfully discharged (p-value = <0.00001), and 5 % deceased (p-value = <0.00001). Microbiological and antibiotic susceptibility testing was performed on patient samples to determine MDRB and assess their resistance profiles. The outcomes exhibited an increase in MDRB prevalence in 2022 (standard error, SE, ± 0.0351 to ± 0.0936) compared to 2021 (SE ± 0.0380 to ± 0.0654) and 2023 (SE ± 0 to ± 0.1158). Gammaproteobacteria was predominant across the recovered samples. Klebsiella pneumoniae (40 %), Escherichia coli (28 %), Citrobacter sp. (19 %), Acinetobacter sp. (7 %), and Pseudomonas aeruginosa (6 %) were recognized as the predominant populations. The Shapiro-Wilk test for normality varied from 0.800 to 0.888 (p-value = <0.081–0.351), while the Anderson-Darling test ranged from 0.343 to 0.511 (p-value = <0.098–0.315). These MDRB exhibited Shannon and Simpson index values ranging from 1.138 to 1.508 and 0.643–0.775, respectively, with evenness values from 0.780 to 1.042, indicating microbial diversity in the patient samples. In antibiotic susceptibility testing, Acinetobacter sp. Citrobacter sp., Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae showed 100 % resistance to 23, 15, 14, 13, and 11 antibiotics, respectively. Further, compared to prior reports (de Souza et al., 2023, p-value = 0.00001, and Ruegsegger et al., 2022, p-value = <0.0061), the percentages of MDRB, i.e. Klebsiella pneumoniae (40 %), Escherichia coli (28 %), and Citrobacter sp. (19 %), were significantly higher (p-value = <0.00001) in this study. Overall, the MDRB distribution changed in prevalence across different years (2021 – 2023, during and post-COVID-19 pandemic) and medical conditions. Despite the high antibiotic resistance, the fatality rate in this study was lower than in other available reports, suggesting that effective recovery is possible with rapid and tailored treatment. These outcomes indicate the requirement for enhanced surveillance, monitoring, and targeted treatment strategies to manage ABR effectively.

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The Microbe

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