Chinese Medical Sciences Journal ›› 2020, Vol. 35 ›› Issue (4): 315-322.doi: 10.24920/003675

• 论著 • 上一篇    下一篇

巴基斯坦三级医院小儿血流感染的细菌谱和抗菌谱

Anees Muhammad1,4,Sadiq Noor Khan1,Tahir Jamal2,Irshad Ul Haq3,Abdul Jabbar1,Ihsan Ali5,*()   

  1. 1哈里浦大学基础与应用科学学院医学实验室技术系,哈里普,22620巴基斯坦
    2雷曼医学研究所,白沙瓦,22620巴基斯坦
    3哈里浦大学基础与应用科学学院微生物学系,哈里浦,22620巴基斯坦
    4巴查汗医学院医学技术学院,马丹,23200 巴基斯坦
    5开伯尔医科大学附属医学科学研究所,白沙瓦,22620 巴基斯坦
  • 收稿日期:2019-10-29 接受日期:2020-04-30 出版日期:2020-12-31 发布日期:2020-10-28
  • 通讯作者: Ihsan Ali E-mail:ihsanmicro@gmail.com

Bacterial Spectrum and Antimicrobial Profile of Pediatric Blood Stream Infection at a Tertiary Care Hospital in Pakistan

Anees Muhammad1,4,Sadiq Noor Khan1,Tahir Jamal2,Irshad Ul Haq3,Abdul Jabbar1,Ihsan Ali5,*()   

  1. 1Department of Medical Laboratory Technology, University of Haripur, Haripur, Khyber Pathtunkhwa (KPK) 22620, Pakistan
    2Rehman Medical Institute (RMI), Peshawar, KPK 22620, Pakistan
    3Department of Microbiology, University of Haripur, Haripur, KPK 22620, Pakistan
    4College of Medical Technology, Bacha Khan Medical College, Mardan, KPK 23200, Pakistan
    5Institute of Paramedical Sciences, Khyber Medical University, Peshawar, KPK 22620, Pakistan
  • Received:2019-10-29 Accepted:2020-04-30 Published:2020-12-31 Online:2020-10-28
  • Contact: Ihsan Ali E-mail:ihsanmicro@gmail.com

摘要:

目的 血流感染(blood stream infection, BSI)是全球范围儿童发病和死亡的主要原因之一。本研究旨在确定BSI的流行程度,重点是鉴定BSI的病原体,并进一步评估致病细菌病原体的抗生素敏感性。
方法 于2018年1月至12月在巴基斯坦白沙瓦的三级医院进行横断面研究。血液样本采集于在BACTECTM瓶中,采用标准的微生物学方法对细菌菌株进行分离和鉴定。依据临床实验室标准化协会(Clinical Laboratory Standard Institute, CLSI)2014年指南,使用圆盘扩散法进行抗生素敏感性测试。
结果 共进行567次血液培养,其中BSI阳性111例(19.6%)。在阳性血培养中,男童占64%(71/111),女童占36%(40/111)。微生物的致病优势菌群为革兰氏阴性菌79株(71.1%),革兰氏阳性菌32株(28.9%)。分离株的常见细菌是伤寒沙门氏菌(n=35,31.5%),大肠杆菌(n=19,17.1%),金黄色葡萄球菌(n=18,16.2%),肺炎克雷伯菌(n=12,10.8%),及肠球菌(n=7,6.3%)。有36.7%(29/79)的革兰氏阴性菌分离株是超广谱β-内酰胺酶(ESBL)产生者。61.1%(11/18)的金黄色葡萄球菌菌株对甲氧西林耐药。总体而言,72.9%的分离株具有多重耐药性。
结论 革兰氏阴性菌是儿童血流感染的主要病因,伤寒沙门氏菌是主要的致病菌,而大多数伤寒沙门氏菌分离株对环丙沙星耐药。

关键词: 抗生素耐药性, 血流感染, 儿科, 巴基斯坦

Abstract:

Objectives Blood stream infections (BSIs) are the main cause of morbidity and mortality in children worldwide. The present study was carried out to determine the prevalence of BSI with a focus on the identification of the causative agent of BSI, and to further evaluate the antibiotic susceptibility profile of the causing bacterial pathogens.
Methods A cross-section study was carried out at the tertiary care hospital in Peshawar, Pakistan from January to December, 2018. Blood samples were collected in BACTECTM bottles and standard microbiological protocols were applied for the isolation and identification of bacterial strains. The antibiotic susceptibility tests were performed using disc diffusion method as per the 2014 guideline of Clinical Laboratory Standard Institute (CLSI).
Results Of 567 blood cultures in total, 111(19.6%) were positive for BSI. Male children were 64 % (71/111) and female children were 36% (40/111). For the causative predominant group of microorganisms, Gram-negative bacteria were identified in 79 (71.1%) isolates, and Gram-positive bacteria in 32 (28.9%) isolates. The common bacteria of isolates were S. typhi (n=35, 31.5%), E. coli (n=19, 17.1%), S. aureus (n=18, 16.2%), K. pneumonia (n=12, 10.8%), and Enterococcus species (n=7, 6.3%). The 36.7% (29/79) isolates of Gram-negative bacteria were ESBL producers, and 61.1% (11/18) of S. aureus isolates were methicillin resistant. Overall, 72.9% isolates were multidrug resistant.
Conclusions Gram-negative bacteria were the main cause of pediatric BSIs, where the predominant microorganism was S. typhi. Remarkably, majority of the S. typhi isolates were resistant to ciprofloxacin.

Key words: antibiotic resistance, blood stream infections, pediatric, Pakistan

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