埃塞俄比亚南部的细菌性血流感染

M. Hailemariam, Tsegaye Alemayehu, asnakech agegnehu, Mulubrhan Ali, Enkosilassie Mitiku, Elshaday Azerefegne
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摘要

背景:在低收入和中等收入国家,主要由耐药病原体引起的儿童血流感染是医院死亡率较高的风险之一。本研究旨在评估埃塞俄比亚南部5岁以下儿童血液感染分离株的细菌谱和耐药性。方法:回顾性检索哈瓦萨大学综合专科医院的实验室记录资料,评估细菌分离株及耐药性。结果:323例血培养中,潜在细菌BSI阳性116例(35.9%)。血培养阳性率随年龄增长而降低,因此新生儿血流感染率高于其他年龄组(OR, 3;95% ci 1.5-5.1;p = 0.001)。主要革兰氏阳性分离物con和金黄色葡萄球菌对青霉素和四环素的耐药性最高,分别为61.3%和78.8%,而对美罗培南、头孢曲松和强力霉素的耐药性较低,分别为6.4%、13%和13%。虽然大多数革兰氏阴性分离株对所测抗生素具有耐药性,但肺炎克雷伯菌对头孢噻肟和氯霉素的耐药性较弱。结论:报告了高水平的血流感染并伴有高耐药分离株。据报道,新生儿的负担比其他儿童重。因此,为了减轻负担,医院管理人员需要建立有效的感染预防和控制规划、有效的卫生习惯和运转良好的环境,并对患者进行适当的卫生习惯教育。
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Bacterial Blood Stream Infection in Southern Ethiopia
Background: Children’s blood stream infections mainly due to resistant pathogens found to be a higher risk of hospital mortality in low and middle income countries. This study intended to assess the bacterial profile and drug resistance of isolates of blood stream infection among under- 5 children in Southern Ethiopia. Methods: Retrospectively lab recorded data’s were retrieved to assess the bacterial isolates and rates antibiotic resistance at Hawassa University Comprehensive Specialized Hospital. Results: Of 323 bloods culture performed 116 (35.9%) were positive for potential bacterial BSI. Positivity of blood culture decrease with age, hence neonates blood stream infection stream infection were higher than other age groups (OR, 3; 95% CI 1.5–5.1; p=0.001). The major gram positive isolate CoNS and S. aureus have shown highest level of resistance to penicillin 61.3% and tetracycline 78.8% whereas less level of resistance was reported to Meropenem 6.4%, Ceftriaxone 13% and doxycycline 13%. Although most of gram negatives isolates were resistant for tested antibiotics, K. pneumoniae has shown leaser resistance to cefotaxime and chloramphenicol. Conclusion: A high level of blood stream infection accompanied by high drug resistant isolates was reported. The great burden in neonate than other children was reported. As a result to reduce the burden the hospital administrators need to facilities effective infection prevention and control programmes, effective hygiene practices and well-functioning environment along with educating patient about proper hygiene practices.
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