孟加拉国达卡三级医院临床分离金黄色葡萄球菌的流行病学和抗生素谱

F. Alam, T. Tasnim, Sonia Afroz, A. Alam, Nabila Afroze, Aysha Khatun, Sanjida Khondakar Setu, A. Saleh
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摘要

背景:本研究旨在调查孟加拉国达卡三所三级医院临床分离的金黄色葡萄球菌的流行病学和抗生素谱。方法:对2016年3月至2017年2月临床分离的185株金黄色葡萄球菌进行研究,采用标准微生物学方法进行鉴定,采用圆盘扩散法测定抗菌谱。采用双链聚合酶链反应(PCR)检测金黄色葡萄球菌的femA和mecA基因。结果:185株菌株中femA基因全部阳性(100%),耐甲氧西林金黄色葡萄球菌(MRSA) 76株(41.1%),耐甲氧西林金黄色葡萄球菌(MSSA) 109株(58.9%)。脓和尿标本中分别分离出最高和最低的MRSA。185株金黄色葡萄球菌对万古霉素和利奈唑胺均100%敏感,对利福平(94%)、美罗培南(87%)、庆大霉素(85.4%)、复方新诺明(82.2%)高度敏感,对青霉素G最高(94.6%),其次是阿莫西林/克拉维酸(82.7%)、阿奇霉素(72.4%)、阿莫西林(66.5%)、环丙沙星(63.2%)。继万古霉素、利奈唑胺之后,MRSA对利福平、复方新诺明、庆大霉素的敏感性较高,而MSSA对利福平、庆大霉素、头孢西丁、美罗培南、氯西林、头孢曲松、复方新诺明的敏感性较高。此外,MRSA对抗生素的耐药性明显高于MSSA (P值<0.05),金黄色葡萄球菌(81.1%)、MRSA(97.4%)和MSSA(69.7%)以多药耐药(MDR)为主。结论:本研究结果可以指导医生提供有效的抗生素治疗,实施监测和控制策略,减少抗生素耐药性,防止MRSA和MDR在环境中的传播。
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Epidemiology and Antibiogram of Clinical Staphylococcus aureus Isolates from Tertiary Care Hospitals in Dhaka, Bangladesh
Background: This study aimed to investigate the epidemiology and antibiogram of clinical Staphylococcus aureus isolates from three tertiary care hospitals in Dhaka , Bangladesh. Methods: A total of 185 clinical S. aureus isolates were studied from March 2016 to February 2017 and identified by standard microbiological methods and an antibiogram was determined by disc diffusion method. A duplex polymerase chain reaction (PCR) assay was performed on all isolates to detect femA and mecA genes of S. aureus. Results: Among the 185 isolates, all (100%) were positive for the femA gene, 76 (41.1%) were methicillinresistant S. aureus (MRSA), and 109 (58.9%) were methicillin-susceptible S. aureus (MSSA). The highest and the lowest frequency of both MRSA were isolated from pus and urine specimens, respectively. All 185 S. aureus were 100% sensitive to both vancomycin and linezolid and were highly sensitive towards rifampicin (94%), meropenem (87%), gentamicin (85.4%), and cotrimoxazole (82.2%), whereas the highest resistance was against penicillin G (94.6%) followed by amoxicillin/clavulanic acid (82.7%), azithromycin (72.4%), amoxicillin (66.5%), and ciprofloxacin (63.2%). After vancomycin and linezolid, MRSA showed good susceptibility to rifampicin, cotrimoxazole, and gentamicin, while MSSA exhibited high sensitivity toward rifampicin, gentamicin, cefoxitin, meropenem, cloxacillin, ceftriaxone, and cotrimoxazole. Furthermore, MRSA was significantly more resistant to antibiotics than MSSA (P value<0.05), and the majority of S. aureus (81.1%), MRSA (97.4%), and MSSA (69.7%) were multidrug-resistant (MDR). Conclusion: Our findings can guide physicians to provide effective antibiotic therapy, implement monitoring and control strategies to reduce antimicrobial resistance, and prevent the dissemination of MRSA and MDR in the environment.
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