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Antimicrobial resistance in hospitalized surgical patients: a silently emerging public health concern in Benin
Annals of Clinical Microbiology and Antimicrobials ( IF 5.7 ) Pub Date : 2020-11-25 , DOI: 10.1186/s12941-020-00398-4 Carine Laurence Yehouenou 1, 2, 3 , Arsène A Kpangon 4 , Dissou Affolabi 2, 3, 5 , Hector Rodriguez-Villalobos 6, 7 , Françoise Van Bambeke 1, 8 , Olivia Dalleur 1, 9 , Anne Simon 6, 7
Annals of Clinical Microbiology and Antimicrobials ( IF 5.7 ) Pub Date : 2020-11-25 , DOI: 10.1186/s12941-020-00398-4 Carine Laurence Yehouenou 1, 2, 3 , Arsène A Kpangon 4 , Dissou Affolabi 2, 3, 5 , Hector Rodriguez-Villalobos 6, 7 , Françoise Van Bambeke 1, 8 , Olivia Dalleur 1, 9 , Anne Simon 6, 7
Affiliation
Surgical site infections are related to high morbidity, mortality and healthcare costs. Because the emergence of multidrug-resistant bacteria in hospitals is becoming a worldwide challenge for surgeons who treat healthcare-associated infections, we wished to identify the causative agents involved in these infections and the rate of multidrug-resistant bacteria in six public hospitals in Benin. Using standard microbiological procedures, we processed pus specimens collected from obstetrics and gastrointestinal surgery wards. Mass spectrometry (MALDI-TOF) was used for confirmation. For the antibiotic susceptibility test, we first used the Kirby-Bauer disk diffusion method. The secondary test (by microdilution) used the Beckton Dickinson Phoenix automated system (Becton Dickinson Diagnostic, USA). We included 304 patients, whose median length of stay was 9 days. A total of 259 wound swabs (85.2%) had positive aerobic bacterial growth. In obstetrics, S. aureus (28.5%, n = 42) was the most common isolate. In contrast, Gram-negative bacteria (GNB) were predominant in gastrointestinal surgery, the most dominant being E.coli (38.4%, n = 31). Overall, 90.8% (n = 208) of aerobic bacteria were multidrug resistant. Two-thirds of S. aureus (65.3%, n = 32) were methicillin-resistant Staphylococcus aureus (MRSA), three of which carried both MRSA and induced clindamycin resistance (ICR). GNB showed high resistance to ceftazidime, ceftriaxone and cefepime. Extended-spectrum beta-lactamases were presented by 69.4% of E.coli (n = 43/62) and 83.3% of K. pneumoniae (n = 25/30). Overall, twelve Gram-negative bacteria (5.24%) showed resistance to at least one carbapenem. No isolates showed a wild-type susceptible phenotype. This study shows the alarming prevalence of multidrug-resistant organisms from surgical site infections in Benin hospitals. To reduce the spread of such bacteria in Benin, periodic surveillance of surgical site infections and strict adherence to good hand-hygiene practice are essential.
中文翻译:
住院手术患者的抗菌药物耐药性:贝宁悄然出现的公共卫生问题
手术部位感染与高发病率、死亡率和医疗费用有关。由于医院中多重耐药细菌的出现正在成为治疗医疗相关感染的外科医生面临的全球性挑战,我们希望确定这些感染的病原体以及贝宁六家公立医院多重耐药细菌的比率。我们使用标准微生物学程序处理从产科和胃肠外科病房收集的脓液样本。使用质谱(MALDI-TOF)进行确认。对于抗生素敏感性试验,我们首先使用Kirby-Bauer纸片扩散法。二次测试(通过微量稀释)使用 Beckton Dickinson Phoenix 自动化系统(Becton Dickinson Diagnostic,美国)。我们纳入了 304 名患者,中位住院时间为 9 天。共有 259 份伤口拭子(85.2%)有需氧细菌生长阳性。在产科中,金黄色葡萄球菌(28.5%,n = 42)是最常见的分离株。相比之下,革兰氏阴性菌(GNB)在胃肠道手术中占主导地位,其中最主要的是大肠杆菌(38.4%,n = 31)。总体而言,90.8% (n = 208) 的需氧细菌具有多重耐药性。三分之二的金黄色葡萄球菌(65.3%,n = 32)是耐甲氧西林金黄色葡萄球菌(MRSA),其中三种同时携带 MRSA 并诱导克林霉素耐药性(ICR)。GNB对头孢他啶、头孢曲松和头孢吡肟表现出高度耐药性。69.4% 的大肠杆菌 (n = 43/62) 和 83.3% 的肺炎克雷伯菌 (n = 25/30) 存在超广谱 β-内酰胺酶。总体而言,12 种革兰氏阴性菌(5.24%)对至少一种碳青霉烯类抗生素表现出耐药性。没有分离株表现出野生型易感表型。这项研究表明,贝宁医院手术部位感染引起的多重耐药微生物的流行率令人震惊。为了减少此类细菌在贝宁的传播,定期监测手术部位感染并严格遵守良好的手部卫生习惯至关重要。
更新日期:2020-11-25
中文翻译:
住院手术患者的抗菌药物耐药性:贝宁悄然出现的公共卫生问题
手术部位感染与高发病率、死亡率和医疗费用有关。由于医院中多重耐药细菌的出现正在成为治疗医疗相关感染的外科医生面临的全球性挑战,我们希望确定这些感染的病原体以及贝宁六家公立医院多重耐药细菌的比率。我们使用标准微生物学程序处理从产科和胃肠外科病房收集的脓液样本。使用质谱(MALDI-TOF)进行确认。对于抗生素敏感性试验,我们首先使用Kirby-Bauer纸片扩散法。二次测试(通过微量稀释)使用 Beckton Dickinson Phoenix 自动化系统(Becton Dickinson Diagnostic,美国)。我们纳入了 304 名患者,中位住院时间为 9 天。共有 259 份伤口拭子(85.2%)有需氧细菌生长阳性。在产科中,金黄色葡萄球菌(28.5%,n = 42)是最常见的分离株。相比之下,革兰氏阴性菌(GNB)在胃肠道手术中占主导地位,其中最主要的是大肠杆菌(38.4%,n = 31)。总体而言,90.8% (n = 208) 的需氧细菌具有多重耐药性。三分之二的金黄色葡萄球菌(65.3%,n = 32)是耐甲氧西林金黄色葡萄球菌(MRSA),其中三种同时携带 MRSA 并诱导克林霉素耐药性(ICR)。GNB对头孢他啶、头孢曲松和头孢吡肟表现出高度耐药性。69.4% 的大肠杆菌 (n = 43/62) 和 83.3% 的肺炎克雷伯菌 (n = 25/30) 存在超广谱 β-内酰胺酶。总体而言,12 种革兰氏阴性菌(5.24%)对至少一种碳青霉烯类抗生素表现出耐药性。没有分离株表现出野生型易感表型。这项研究表明,贝宁医院手术部位感染引起的多重耐药微生物的流行率令人震惊。为了减少此类细菌在贝宁的传播,定期监测手术部位感染并严格遵守良好的手部卫生习惯至关重要。