肠道病原体的流行和抗生素耐药性:对一家教学医院收治的患者进行的为期六年的主动监测研究结果

Nadia Marascio, Grazia Pavia, Brunella Brescia, Concetta Riillo, Giorgio Settimo Barreca, Luigia Gallo, Cinzia Peronace, Simona Gigliotti, Marta Pantanella, Angelo Giuseppe Lamberti, Giovanni Matera, Angela Quirino
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引用次数: 0

摘要

背景:急性感染性腹泻(AID)及其相关的短期和长期并发症是全球住院治疗的主要原因。在意大利,由于缺乏强有力的监测计划,有关其流行和传播的数据非常有限。本研究旨在评估六年内肠道病原体的耐药性模式及其流行趋势。研究方法这项横断面回顾性研究于 2018 年 1 月至 2023 年 12 月进行。在常规诊断过程中使用培养方法、综合征分子检测和酶免疫测定对粪便样本进行分析。结果显示细菌是分离最多的肠道病原体(62.2%),其次是真菌(29.0%)、病毒(8.2%)和寄生虫(0.6%)。大多数细菌是从门诊病人(29.5%)和肿瘤科病房病人(26.2%)身上分离出来的。最常见的细菌是 EPEC(11.1%),其次是艰难梭菌毒素 A/B 产毒菌株(8.3%)、空肠肠杆菌(2.5%)和肠杆菌(1%)。诺如病毒和念珠菌属在儿科患者中最常见(分别为 6.5% 和 39.6%)。在过去几年中,肠道病原体已成为一种常见的感染病因,其特点是对常见抗菌药具有抗药性。在我们的研究中,肠炎双球菌显示出对阿米卡星、庆大霉素、氨苄西林、左氧氟沙星和环丙沙星的耐药性。空肠肠杆菌对所有测试药物均呈敏感性。结论及时通报肠胃感染病例对于确定潜在疫情源头、确保严格遵守食品安全和卫生规范以保护最易受感染人群至关重要。本研究有助于深入了解主要肠道 AID 病原体的流行病学特征和抗生素敏感性,以便在医疗机构实施感染控制措施。
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Prevalence of Enteric Pathogens and Antibiotic Resistance: Results of a Six-Year Active Surveillance Study on Patients Admitted to a Teaching Hospital
Background: Acute Infectious Diarrhea (AID) and the short- and long-term complications associated with it are major causes of hospitalization worldwide. In Italy, due to a lack of robust surveillance programs, only limited data has been collected on their prevalence and circulation. This study aims to evaluate the resistance pattern of enteric pathogens and their epidemiological trends over a six-year period. Methods: This cross-sectional retrospective study was conducted from January 2018 to December 2023. Stool samples were analyzed during routine diagnosis with culture methods, syndromic molecular tests, and enzyme immunoassay. Results: Bacteria were the most isolated enteric pathogens (62.2%), followed by fungi (29.0%), viruses (8.2%), and parasites (0.6%). Most bacteria were isolated from outpatients (29.5%) and from patients in the Oncology ward (26.2%). The most prevalent target was EPEC (11.1%), followed by C. difficile toxin A/B-producing strains (8.3%), C. jejuni (2.5%), and S. enterica, (1%.). Norovirus and Candida spp. were the most prevalent in pediatric patients (6.5% and 39.6%, respectively). In the last years, enteric pathogens have been a frequent cause of infections characterized by a problematic resistance to common antimicrobials. In our study, S. enterica showed resistance to amikacin, gentamicin, ampicillin, levofloxacin, and ciprofloxacin. C. jejuni was susceptible to all tested drugs. Conclusion: Timely notification of gastroenteric infections is crucial in identifying potential outbreak sources and ensuring strict adherence to food safety and hygiene practices, so as to protect the most vulnerable populations. The present study offers insights into the epidemiological characteristics and the antibiotic susceptibility of the main enteric AID pathogens in order to implement infection control measures in health care settings.
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