洞察印度一家三级医院重症监护室住院病人分离出的细菌病原体的抗菌药耐药性负担

Garima Gautam, Shweta Satija, Ravinder Kaur, Anil Kumar, Divakar Sharma, Megh Singh Dhakad
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摘要

重症监护室(ICU)患者很容易受到医院流行病菌的感染。本研究旨在确定一家三级医院重症监护室患者不同感染的细菌学特征及其耐药性模式。研究分析了一家三甲医院所有重症监护室在 2020 年 1 月至 2022 年 5 月期间收治的患者的培养报告记录。共从 2308 名患者身上获得了 3056 份样本。结果发现,重症监护室患者的感染率为 53.40%。男性(50.86%)和女性(49.14%)所占比例相当。最常见的培养阳性临床样本是血液(39.08%),其次是呼吸道样本(29.45%)。从各种临床标本中分离出的最常见微生物是不动杆菌(33.02%),其次是肺炎克雷伯菌(20.89%)和大肠埃希菌(13.8%)。超过 80% 的醋氨曲霉菌对第三代头孢菌素、氨基糖苷类和碳青霉烯类产生耐药性,而米诺环素(56.31% S)和可乐定(100% S)则是最有效的药物。克雷伯氏菌的耐药性高于大肠杆菌,耐药性最低的是四环素(43.97%)和强力霉素(55.84%)。在金黄色葡萄球菌中,82.78%的菌株耐甲氧西林(MRSA)。耐万古霉素肠球菌(VRE)占分离菌株的 16.67%。有关本地细菌生物及其抗菌药耐药性模式的循证知识在决定经验性药物疗法方面至关重要,最终将导致抗菌药耐药性(AMR)的管理。
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Insight into the Burden of Antimicrobial Resistance among Bacterial Pathogens Isolated from Patients Admitted in ICUs of a Tertiary Care Hospital in India
Intensive care unit (ICU) patients are prone to develop infections by hospital prevalent organisms. The aim of the study was to determine the bacteriological profiles and their drug resistance pattern among different infections in ICU patients of a tertiary care hospital. The record-based retrospective data of culture reports of the patients admitted to all the ICUs of a tertiary care hospital during the period from January 2020 to May 2022 were analyzed. A total of 3,056 samples were obtained from 2308 patients. The infection rate among ICU patients was found to be 53.40%. Isolates belonged equally to males (50.86%) and females (49.14%). The most common culture-positive clinical specimen received was blood (39.08%) followed by respiratory samples (29.45%). Acinetobacter sp. (33.02%) was the most common organism isolated from various clinical specimens, followed by Klebsiella pneumoniae (20.89%), and Escherichia coli (13.8%). More than 80% of Acinetobacter species were found to be resistant to third-generation cephalosporins, aminoglycosides, and carbapenems, whereas minocycline (56.31% S) and colistin (100% S) were the most effective drugs. Klebsiella sp. was found to be more resistant than E.coli, and the least resistance was observed to be tetracycline (43.97%) and doxycycline (55.84%). Among Staphylococcus aureus, 82.78% of strains were methicillin-resistant (MRSA). Vancomycin-resistant Enterococci (VRE) sp. accounted for 16.67% of the isolates. Evidence-based knowledge regarding the local bacterial organisms and their antimicrobial resistance pattern is pivotal in deciding empirical drug therapy, ultimately leading to the management of antimicrobial resistance (AMR).
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