尼泊尔西部拜拉哈瓦通用医学院就诊患者感染的趋势与特征：2018年纵向研究
Trend and Characteristics of Infections in Patients Attending Universal College of Medical Sciences, Bhairahawa, Western Nepal: A Longitudinal Study of 2018.
作者信息
Raut Shristi, Rijal Komal Raj, Khatiwada Sulochana, Karna Subash, Khanal Rita, Adhikari Janak, Adhikari Bipin
机构信息
Department of Microbiology, Universal College of Medical Sciences, Bhairahawa, Nepal.
Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal.
出版信息
Infect Drug Resist. 2020 Jun 8;13:1631-1641. doi: 10.2147/IDR.S257851. eCollection 2020.
BACKGROUND
is one of the major organisms causing nosocomial infections and is intrinsically resistant to multiple classes of antibiotics. The main objective of this study was to investigate the trend and characteristics of infections including its resistance pattern among patients attending Universal College of Medical Sciences, Teaching Hospital (UCMSTH) in Western Nepal, between January and December 2018.
PATIENTS AND METHODS
A total of 4862 clinical samples received at the microbiology laboratory of UCMSTH over a period of a year were analyzed. Following bacterial culture on the samples, culture-positive isolates were tested for antibiotic susceptibility using a modified Kirby-Bauer method. The demographic profile of the patient, information about samples, and the antibiotic profile of the isolated from different samples were recorded and analyzed.
RESULTS
A total of 1180 (24.2%; 1180/4862) organisms were isolated from the total samples. (12.4%; 147/1180) was the third most common organism. Prevalence of was found to be high in late summer/early winter (July: 15.9%; 18/113 and December: 18.8%; 13/69). The majority 71.4% (n=105) of isolates were multidrug resistant (MDR). None of the isolate was pan-drug resistant. Colistin, polymyxin B, and tigecycline were 100% sensitive to . MDR bacteria were significantly associated with the gender of the patients [female: 51.4% (54/105) versus male: 48.6% (51/105); =0.05], clinical specimens [swab: 40% (42/105) sputum: 21.9% (23/105) and urine: 10.5% (11/105); =0.02] and different wards of the hospital [surgery: 30.5% (32/105); ICU: 21.9% (23/105) and medicine: 19.0% (20/105); < 0.03].
CONCLUSION
The high burden of MDR isolates in clinical specimens shows an alarming presence of antimicrobial resistance. Two-thirds of the specimens showed MDR and were associated with demographic and clinical characteristics of the patients. In the management of infectious diseases at UCMSTH, there should be a high suspicion of infection, and isolation and treatment should be carried out based on an antibiotic susceptibility test.
背景
是引起医院感染的主要病原体之一，对多种抗生素具有内在耐药性。本研究的主要目的是调查2018年1月至12月在尼泊尔西部通用医学科学学院教学医院（UCMSTH）就诊的患者中感染的趋势和特征，包括其耐药模式。
患者和方法
对UCMSTH微生物实验室一年内收到的4862份临床样本进行了分析。对样本进行细菌培养后，采用改良的 Kirby-Bauer 方法对培养阳性的分离株进行抗生素敏感性测试。记录并分析患者的人口统计学资料、样本信息以及从不同样本中分离出的抗生素谱。
结果
从全部样本中共分离出1180株（24.2%；1180/4862）病原体。是第三大常见病原体（12.4%；147/1180）。发现在夏末/初冬时的感染率较高（7月：15.9%；18/113；12月：18.8%；13/69）。大多数（71.4%，n = 105）分离株对多种药物耐药（MDR）。没有分离株对所有药物均耐药。黏菌素、多黏菌素B和替加环素对该病原体的敏感性为100%。多重耐药菌与患者性别[女性：51.4%（54/105），男性：48.6%（51/105）；P = 0.05]、临床标本[拭子：40%（42/105），痰液：21.9%（23/105），尿液：10.5%（11/105）；P = 0.02]以及医院的不同科室[外科：30.5%（32/105）；重症监护病房：21.9%（23/105），内科：19.0%（20/105）；P < 0.03]显著相关。
结论
临床标本中多重耐药分离株的高负担表明存在令人担忧的抗菌药物耐药性。三分之二的标本显示为多重耐药，并且与患者的人口统计学和临床特征相关。在UCMSTH的传染病管理中，应高度怀疑感染，并根据抗生素敏感性试验进行隔离和治疗。
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