埃塞俄比亚西南部某三级教学医院慢性阻塞性肺疾病急性加重患者的细菌分离和抗菌药物耐药模式

IF 2.6
Abdulhakim Mussema, Getenet Beyene, Mulatu Gashaw
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引用次数: 3

摘要

慢性阻塞性肺疾病(COPD)是世界范围内慢性发病率和死亡率的主要原因。慢性阻塞性肺病的自然病程以急性加重为特征。感染性病原体,特别是细菌,在大多数情况下会导致慢性阻塞性肺病的恶化。本研究旨在确定吉马医疗中心慢性阻塞性肺病急性加重期(AECOPD)患者的细菌学和抗生素耐药性模式。方法:于2019年3月至10月进行横断面研究。从39名被诊断为AECOPD的研究参与者中收集了人口统计学、临床和痰样本。采用标准细菌学技术鉴定病原菌,采用Kirby Bauer纸片扩散法进行药敏试验。利用MASTTM D68C和MASTTM D73C组合光盘分别鉴定了广谱β-内酰胺酶(es - β l)和碳青霉烯酶的产生。计算卡方比和比值比。结果:总体而言,69.2%(27/39)的痰标本被证实为培养阳性。检出革兰氏阴性菌78.1%(25/32),革兰氏阳性菌21.9%(7/32)。优势菌群分别为铜绿假单胞菌21.9%(7/32)、肺炎克雷伯菌18.75%(6/32)、金黄色葡萄球菌15.62%(7/32)。总体而言,30株(93.8%)菌株具有多重耐药(MDR)。分别有48%(12/25)和8%(32%)的革兰氏阴性分离菌产生ESBL β -二酶和OXA-48碳青霉烯酶。在过去一年中有两次或两次以上的恶化经历被发现是痰培养阳性的重要决定因素。结论:从AECOPD患者中分离出高比例的耐多药、ESBL和碳青霉烯酶产生菌。经验性抗生素治疗应考虑耐药病原体的患病率和可能增加耐多药细菌病原体发生的因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Bacterial Isolates and Antibacterial Resistance Patterns in a Patient with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in a Tertiary Teaching Hospital, Southwest Ethiopia.

Introduction: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality worldwide. The natural course of COPD is characterized by acute exacerbation. Infectious agents, particularly bacteria, cause exacerbation of COPD in the majority. This study aimed to determine the bacteriology and antibiotic resistance patterns among patients with acute exacerbations of COPD (AECOPD) at Jimma Medical Center.

Methods: A cross-sectional study was conducted from March to October 2019. Demographic, clinical, and sputa samples were collected from 39 study participants, who were diagnosed with AECOPD. Bacterial pathogens were identified using standard bacteriological techniques, and anti-microbial susceptibility testing was done by Kirby Bauer's disk diffusion method. Extended-spectrum β-lactamase (ESβL) and carbapenemase production were confirmed by MASTTM D68C and MASTTM D73C combination disc sets, respectively. Chi-square and odds ratios were calculated.

Results: Overall, 69.2% (27/39) of sputum samples were confirmed to be culture-positive. A total of 32 bacterial isolates with 78.1% (25/32) Gram-negative and 21.9% (7/32) Gram-positive bacteria were identified. The predominant bacterial isolates were Pseudomonas aeruginosa 21.9% (7/32), Klebsiella pneumoniae 18.75% (6/32), and Staphylococcus aureus 15.62% (7/32). Overall, 30 (93.8%) of the isolates were multidrug-resistant (MDR). About 48% (12/25) and 8 (32%)of gram negative bacterial isolates were ESBL betalatemase and OXA-48 carbapenemase producers, respectively. Having two or more exacerbation experiences in the previous year were found to be important determinants of the sputum culture positivity.

Conclusions: High rates of MDR, ESBL, and carbapenemase producer bacteria were isolated from patients with AECOPD. Empiric antibiotic therapy should consider the prevalence of antibiotic-resistant pathogens and the factor that may increase the occurrence of MDR bacterial pathogens.

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