儿科重症监护病房多重耐药菌流行病学分析

Sara Kouara, Wiame Ghammad, Selma Berrada, Mustapha Mahmoud
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摘要

耐多药细菌目前是我国医院的一个主要健康问题,也是一个当前的医疗问题,因为它引起发病率和死亡率,特别是在重症监护病房。本研究的目的是描述儿科和新生儿重症监护病房多重耐药细菌的流行病学概况、频率和耐药状况。我们于2022年在非斯的哈桑二世大学医院微生物实验室进行了回顾性研究,从这两个单位收集了细菌样本,发现了一种耐多药细菌(MDR)。我们收集了1216份细菌样本,其中28%呈阳性,其中148份含有多重耐药菌。革兰氏阴性菌(GNB)占多数,耐药革兰氏阳性球菌仅4份,鲍曼不动杆菌最常见,其次是肺炎克雷伯菌。在婴儿中发现广谱β -内酰胺酶(ESBL)的比例很高,估计占新生儿重症监护室收集的所有样本的40%,在儿科重症监护室中发现高耐药鲍曼不动杆菌分离株的比例也很高。耐多药医院细菌感染以新生儿菌血症和儿科重症监护肺炎为主,均主要由革兰氏阴性杆菌引起。了解这些细菌的细菌学特征和抗生素耐药率将有助于在每个医院环境中进行更有针对性的管理。
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Epidemiological profile of multi-drug resistant bacteria in pediatric intensive care unit
Multidrug-resistant bacteria are currently a major health problem in our hospitals and a current medical issue due to the morbidity and mortality it causes, especially in intensive care units. The objective of this study is to describe the epidemiological profile, frequency, and resistance status of multidrug-resistant bacteria in pediatric and neonatal intensive care units. We conducted a retrospective study at the microbiology laboratory of the Hassan II University Hospital in Fez in 2022, where we collected bacterial samples from these two units that identified a multidrug-resistant bacteria (MDR). We collected 1216 bacterial samples, of which 28% were positive, and among them, we found 148 samples that contained multidrug-resistant bacteria. Gram-negative bacteria (GNB) dominated, with only 4 resistant gram-positive cocci samples, and Acinetobacter baumannii was the most prevalent, followed by Klebsiella pneumoniae. A high rate of extended-spectrum beta-lactamase (ESBL) was found in infants, estimated at 40% of all samples collected in neonatal intensive care, as well as a high rate of highly resistant isolates of Acinetobacter baumannii in pediatric intensive care. Multidrug-resistant nosocomial bacterial infections are dominated by bacteremia in neonatology and pneumonia in pediatric intensive care, and both are mainly caused by gram-negative bacilli. Knowledge of the bacteriological profiles and antibiotic resistance rates of such bacteria will allow for more tailored and targeted management in each hospital setting.
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