R R Karn, R Acharya, A K Rajbanshi, S K Singh, S K Thakur, S K Shah, A K Singh, R Shah, S Upadhya Kafle, M Bhattachan, A Abrahamyan, H D Shewade, R Zachariah
{"title":"尼泊尔等待手术的慢性耳部分泌物患者的抗生素耐药性。","authors":"R R Karn, R Acharya, A K Rajbanshi, S K Singh, S K Thakur, S K Shah, A K Singh, R Shah, S Upadhya Kafle, M Bhattachan, A Abrahamyan, H D Shewade, R Zachariah","doi":"10.5588/pha.21.0029","DOIUrl":null,"url":null,"abstract":"<p><strong>Setting: </strong>Biratnagar Eye Hospital, Biratnagar, Nepal, which offers ear surgery for chronic suppurative otitis media (CSOM).</p><p><strong>Objective: </strong>In patients with CSOM awaiting surgery, to determine the 1) sociodemographic characteristics 2) bacterial isolates and their antibiotic resistance patterns and 3) characteristics of those refused surgery, including antibiotic resistance.</p><p><strong>Design: </strong>A cohort study using hospital data, January 2018-January 2020.</p><p><strong>Results: </strong>Of 117 patients with CSOM and awaiting surgery, 64% were in the 18-35 years age group, and 79% were cross-border from India. Of 118 bacterial isolates, 80% had <i>Pseudomonas aeruginosa</i> and 16% had <i>Staphylococcus aureus</i>. All isolates showed multidrug resistance to nine of the 12 antibiotics tested. The lowest antibiotic resistance in <i>P. aeruginosa</i> was for vancomycin (29%) and moxifloxacin (36%), and for <i>S. aureus</i>, this was vancomycin (9%) and amikacin (17%). Fourteen (12%) patients underwent surgery: myringoplasty (<i>n</i> = 7, 50%), cortical mastoidectomy with tympanostomy (<i>n</i> = 4, 29%) and modified radical mastoidectomy (<i>n</i> = 3, 21%). Those infected with <i>P. aeruginosa</i> and with resistance to over six antibiotics were significantly more likely to be refused for surgery.</p><p><strong>Conclusion: </strong>Patients awaiting ear surgery were predominantly infected with multidrug-resistant <i>P. aeruginosa</i> and were consequently refused surgery. This study can help inform efforts for improving surgical uptake and introducing cross-border antimicrobial resistance surveillance.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"11 Suppl 1","pages":"1-5"},"PeriodicalIF":1.3000,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575382/pdf/","citationCount":"0","resultStr":"{\"title\":\"Antibiotic resistance in patients with chronic ear discharge awaiting surgery in Nepal.\",\"authors\":\"R R Karn, R Acharya, A K Rajbanshi, S K Singh, S K Thakur, S K Shah, A K Singh, R Shah, S Upadhya Kafle, M Bhattachan, A Abrahamyan, H D Shewade, R Zachariah\",\"doi\":\"10.5588/pha.21.0029\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Setting: </strong>Biratnagar Eye Hospital, Biratnagar, Nepal, which offers ear surgery for chronic suppurative otitis media (CSOM).</p><p><strong>Objective: </strong>In patients with CSOM awaiting surgery, to determine the 1) sociodemographic characteristics 2) bacterial isolates and their antibiotic resistance patterns and 3) characteristics of those refused surgery, including antibiotic resistance.</p><p><strong>Design: </strong>A cohort study using hospital data, January 2018-January 2020.</p><p><strong>Results: </strong>Of 117 patients with CSOM and awaiting surgery, 64% were in the 18-35 years age group, and 79% were cross-border from India. Of 118 bacterial isolates, 80% had <i>Pseudomonas aeruginosa</i> and 16% had <i>Staphylococcus aureus</i>. All isolates showed multidrug resistance to nine of the 12 antibiotics tested. The lowest antibiotic resistance in <i>P. aeruginosa</i> was for vancomycin (29%) and moxifloxacin (36%), and for <i>S. aureus</i>, this was vancomycin (9%) and amikacin (17%). Fourteen (12%) patients underwent surgery: myringoplasty (<i>n</i> = 7, 50%), cortical mastoidectomy with tympanostomy (<i>n</i> = 4, 29%) and modified radical mastoidectomy (<i>n</i> = 3, 21%). Those infected with <i>P. aeruginosa</i> and with resistance to over six antibiotics were significantly more likely to be refused for surgery.</p><p><strong>Conclusion: </strong>Patients awaiting ear surgery were predominantly infected with multidrug-resistant <i>P. aeruginosa</i> and were consequently refused surgery. This study can help inform efforts for improving surgical uptake and introducing cross-border antimicrobial resistance surveillance.</p>\",\"PeriodicalId\":46239,\"journal\":{\"name\":\"Public Health Action\",\"volume\":\"11 Suppl 1\",\"pages\":\"1-5\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2021-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575382/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Public Health Action\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5588/pha.21.0029\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Public Health Action","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5588/pha.21.0029","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Antibiotic resistance in patients with chronic ear discharge awaiting surgery in Nepal.
Setting: Biratnagar Eye Hospital, Biratnagar, Nepal, which offers ear surgery for chronic suppurative otitis media (CSOM).
Objective: In patients with CSOM awaiting surgery, to determine the 1) sociodemographic characteristics 2) bacterial isolates and their antibiotic resistance patterns and 3) characteristics of those refused surgery, including antibiotic resistance.
Design: A cohort study using hospital data, January 2018-January 2020.
Results: Of 117 patients with CSOM and awaiting surgery, 64% were in the 18-35 years age group, and 79% were cross-border from India. Of 118 bacterial isolates, 80% had Pseudomonas aeruginosa and 16% had Staphylococcus aureus. All isolates showed multidrug resistance to nine of the 12 antibiotics tested. The lowest antibiotic resistance in P. aeruginosa was for vancomycin (29%) and moxifloxacin (36%), and for S. aureus, this was vancomycin (9%) and amikacin (17%). Fourteen (12%) patients underwent surgery: myringoplasty (n = 7, 50%), cortical mastoidectomy with tympanostomy (n = 4, 29%) and modified radical mastoidectomy (n = 3, 21%). Those infected with P. aeruginosa and with resistance to over six antibiotics were significantly more likely to be refused for surgery.
Conclusion: Patients awaiting ear surgery were predominantly infected with multidrug-resistant P. aeruginosa and were consequently refused surgery. This study can help inform efforts for improving surgical uptake and introducing cross-border antimicrobial resistance surveillance.
期刊介绍：
Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.
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