喀麦隆雅温得大学教学医院急诊科收治的患者中β -内酰胺酶产生细菌和其他耐药细菌的筛查

Abange William Baiye, Lavoisier Christian Ngassa Yimtchi, Anicette Chafa Betbeui, Noel Achille Teudjieu Dongmo, Hontense Kamga Gonsu
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引用次数: 0

摘要

目的:本研究旨在筛选雅温得大学附属教学医院急诊科收治的患者中β -内酰胺酶(BLs)和其他耐药细菌。研究设计:本研究是一项以医院为基础的横断面研究。研究地点和时间:本研究于2020年2月至6月在喀麦隆雅温德省青年大学细菌学部门进行。方法:收集我院急诊新入院患者尿液样本75份,根据培养特征、革兰氏形态和生化检测鉴定细菌种类。分别采用双盘协同法和圆盘近似法从产广谱β -内酰胺酶(ESBLs)和AmpC BLs的菌株中筛选出菌株。采用纸片扩散法对分离物进行药敏试验。结果:75例尿液中,14例(18.7%)尿路感染阳性。共分离出大肠杆菌(E. coli) 5种、克雷伯菌(Klebsiella) 4种、Citrobacter (Citrobacter) 2种、变形杆菌(Proteus) 2种、肠杆菌(Enterobacter) 14种。对阿莫西林克拉维酸、头孢呋辛、头孢他啶均有较高的耐药性,对碳青霉烯类抗生素均有较高的敏感性。14株分离细菌中有8株为BLs产生菌,其中5株为纯ESBL产生菌,2株为ESBL + AmpC共同产生菌,1株为AmpC产生菌。研究人群中BLs总阳性率为10.7%。同样,患者来源和既往抗生素使用与BLs患病率显著相关,p值分别为0.01和0.04。结论:ß-内酰胺酶在急诊科的高发,强调急诊科需要持续监测耐药菌株,严格指导抗生素治疗,实施感染控制措施,以减轻日益增加的抗生素耐药负担。
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Screening for Beta-Lactamases Producing Bacteria and Other Resistant Bacteria among Patients Admitted to the Emergency Unit at the Yaoundé University Teaching Hospital, Cameroon
Aims: This study aimed to screen for Beta Lactamases (BLs) and other resistant bacteria among patients admitted to the emergency unit of the Yaoundé University Teaching Hospital (YUTH). Study Design: This study was a cross-sectional hospital-based study. Place and Duration of Study: This study was conducted at the Bacteriology unit of the YUTH, Yaoundé- Cameroon between February to June 2020. Methodology: Seventy-Five urine samples were collected from newly admitted patients at the emergency unit of the YUTH and bacteria species were identified basis on their culture characteristics, Gram morphology, and biochemical tests. The isolates were screened from the production of extended-spectrum beta-lactamases (ESBLs) and AmpC BLs using the Double disk synergy method and Disk approximation methods respectively. These isolates were later subjected to antimicrobial susceptibility testing using the disk diffusion method. Results: Out of the 75 urine analyzed, 14 (18.7%) were found positive for Urinary Tract Infection. Fourteen bacteria species were isolated identified and enumerated as E. coli (5), Klebsiella species (4), Citrobacter species (2), Proteus species (2), and Enterobacter species (1). A high level of resistance was observed with Amoxicillin clavulanic acid, Cefuroxime, and Ceftazidime while a high level of sensitivity was observed among carbapenem antibiotics. Eight of 14 isolated bacteria were BLs producers, of which 5 were sorely ESBL producers, 2 co-producers (ESBL + AmpC), and 1 AmpC producer. The overall positive rate of BLs in the study population was 10.7%. Again, patient origin and previous antibiotic use were significantly associated with BLs prevalence p-value of .01 and .04 respectively. Conclusion: The high prevalence of the ß- lactamases in the Emergency unit emphasizes the need for continuous surveillance in the Emergency unit to detect resistant strains, strict guidelines for antibiotic therapy, and the implementation of infection control measures to reduce the increasing burden of antibiotic resistance.
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