喀麦隆雅温得两个区医院0-2岁儿童产生广谱β -内酰胺酶(ESBL)导致败血症的大肠杆菌患病率

Cecile Ingrid Djuikoué, P. D. Djouela Djoulako, Kamga Wouambo Rodrigue, Suzie Lacmago, Audrey Dayomo, H. Kamga, Benjamin D. Thumamo Pokam, T. Apalata
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引用次数: 5

摘要

败血症是世界范围内的公共卫生问题,儿童死亡率很高。喀麦隆关于这一现象的流行病学数据仍然很少。本研究旨在确定喀麦隆yaound两家医院中产生广谱β -内酰胺酶(ESBL)的大肠杆菌菌株引起的败血症的患病率和相关因素。本研究采用前瞻性横断面研究方法,于2019年8月至2020年3月,对雅温德市两家区医院(协和协和医院)会诊和新生儿护理科的0 - 2岁婴幼儿进行了为期7个月的研究。每个婴儿采集的血液样本在血碱性能瓶中培养,并使用api - 20e系统鉴定细菌菌株。此外,根据法国微生物学会2019年抗生素谱委员会的建议,对分离株的抗生素耐药谱和ESBL的生产进行了研究。采用Epi-Info7.0进行数据分析,若p < 0.05,差异有统计学意义。在入选的300名儿童中,130名(43.33%)血培养阳性,大肠杆菌阳性。发病率最高(69.23%(90/130))。药敏试验结果显示,90株大肠杆菌中有77株对青霉素耐药,其中对阿莫西林耐药占85.55%,产生ESBL的占34.44%。免疫缺陷、使用抗生素,特别是服用β-内酰胺等因素与大肠杆菌ESBL产生显著相关([aOR = 19.93;p = 0.0001], [aOR = 1.97;p = 0.04], [aOR = 3.54];P = 0.01])。此外,对氨基糖苷类药物、喹诺酮类药物、氟喹诺酮类药物和复方新诺明也存在共耐药。该研究强调了喀麦隆0-2岁儿童血液样本中大肠杆菌ESBL的高流行率,并促使开发更有效的策略来降低喀麦隆婴儿与大肠杆菌ESBL相关的死亡率。
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Prevalence of Escherichia coli Producing Extended Spectrum Beta-Lactamase (ESBL) Driven Septicaemia in Children Aged 0–2 Years in Two Districts Hospitals in Yaounde, Cameroon
Septicaemia is public health problem worldwide with a high rate of mortality among children. Epidemiological data on this phenomenon in Cameroon are still scarce. This study aimed to determine the prevalence and associated factors to septicaemia due to E. coli strains producing extended spectrum beta-lactamase (ESBL) in two hospitals in Yaoundé, Cameroon. A prospective, cross-sectional study was conducted on infants aged 0 to 2 years old at the consultation and neonatology care unit of two district hospitals of Yaoundé (UTHY and YGOPH) during a period of seven months (from August 2019 to March 2020). Each blood sample collected per infant was cultured in hemoline performance vials, and bacterial strains were identified using the Api-20 E system. In addition, an antibiotic resistant profile of isolates as well as the ESBL production were performed in accordance with the recommendations of the Antibiogram committee of the French Society of Microbiology 2019. Data were analysed in Epi-Info7.0 and for p less than 0.05, the difference was statistically significant. Of the 300 children enrolled, 130 (43.33%) were blood culture positive, and E. coli. was the most prevalent (69.23% (90/130)). Then antibiotic susceptibility test revealed that 77 over 90 E. coli strains were resistant to penicillin (with 85.55% to amoxicillin), and 34.44% were producing ESBL. Factors such as immunodeficiency, being on antibiotics, and particularly taking β-lactam were significantly associated with E. coli ESBL production ([aOR = 19.93; p = 0.0001], [aOR = 1.97; p = 0.04], and [aOR = 3.54; p = 0.01], respectively). Moreover, co-resistance to aminoglycosides, quinolones, fluoroquinolones, and cotrimoxazole were also found. This study highlighted a high prevalence of E. coli ESBL in blood samples of children aged 0–2 years in Yaoundé and prompts the development of more efficient strategies against E. coli ESBL associated mortality in infants in Cameroon.
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