Increasing Antimicrobial Resistance in Surgical Wards at Mulago National Referral Hospital, Uganda, from 2014 to 2018-Cause for Concern?
Increasing Antimicrobial Resistance in Surgical Wards at Mulago National Referral Hospital, Uganda, from 2014 to 2018-Cause for Concern?
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DOI：
10.3390/tropicalmed6020082
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发表时间：
2021-05-19
影响因子：
2.9
通讯作者：
Kajumbula H
中科院分区：
文献类型：
--
作者：
Mboowa G;Aruhomukama D;Sserwadda I;Kitutu FE;Davtyan H;Owiti P;Kamau EM;Enbiale W;Reid A;Bulafu D;Kisukye J;Lubwama M;Kajumbula H
抗菌素耐药性(AMR)和医疗保健相关感染(HAI)是我们这个时代面临的重大全球公共卫生挑战。这项研究提供了2014至2018年间穆拉戈国家转诊医院(MNRH)外科病房AMR趋势的更广泛和最新的概述。有来自428名患者样本的细菌分离株药敏图谱的实验室数据。最常见的标本是：气管抽吸物(36.5%)、脓拭子(28.0%)和血液(20.6%)。以克雷伯菌(21.7%)、不动杆菌(17.5%)、葡萄球菌(12.4%)为主。耐药谱依次为：青霉素类(40-100%)、头孢菌素类(30-100%)、β-内酰胺酶抑制剂组合(70-100%)、碳青霉烯类(10-100%)、多粘菌素E(0-7%)、氨基糖苷类(50-100%)、磺胺类(80-100%)、氟喹诺酮类(40-70%)、大环内酯类(40-100%)、林可酰胺(10-45%)、苯尼考(40-70%)、硝基呋喃(0-25%)、糖肽(0-20%)。这项研究表明，在五年的研究期间，乌干达最常用的抗生素的耐药性持续增加。这意味着需要以医院为基础的持续监测和监测AMR模式，以便为抗生素处方提供信息，并为国家和全球AMR概况做出贡献。它还建议继续强调感染预防和控制做法(IPC)，包括抗生素管理。最终，实验室及时进行细菌学培养和药敏试验的能力将为HAI提供合理的抗生素选择。
Antimicrobial Resistance (AMR) and Healthcare Associated Infections (HAIs) are major global public health challenges in our time. This study provides a broader and updated overview of AMR trends in surgical wards of Mulago National Referral Hospital (MNRH) between 2014 and 2018. Laboratory data on the antimicrobial susceptibility profiles of bacterial isolates from 428 patient samples were available. The most common samples were as follows: tracheal aspirates (36.5%), pus swabs (28.0%), and blood (20.6%). Klebsiella (21.7%), Acinetobacter (17.5%), and Staphylococcus species (12.4%) were the most common isolates. The resistance patterns for different antimicrobials were: penicillins (40–100%), cephalosporins (30–100%), β-lactamase inhibitor combinations (70–100%), carbapenems (10–100%), polymyxin E (0–7%), aminoglycosides (50–100%), sulphonamides (80–100%), fluoroquinolones (40–70%), macrolides (40–100%), lincosamides (10–45%), phenicols (40–70%), nitrofurans (0–25%), and glycopeptide (0–20%). This study demonstrated a sustained increase in resistance among the most commonly used antibiotics in Uganda over the five-year study period. It implies ongoing hospital-based monitoring and surveillance of AMR patterns are needed to inform antibiotic prescribing, and to contribute to national and global AMR profiles. It also suggests continued emphasis on infection prevention and control practices (IPC), including antibiotic stewardship. Ultimately, laboratory capacity for timely bacteriological culture and sensitivity testing will provide a rational choice of antibiotics for HAI.
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影响因子：
1.1
作者：
Ampaire L;Muhindo A;Orikiriza P;Mwanga-Amumpaire J;Bebell L;Boum Y
通讯作者：
Boum Y
影响因子：
168.9
作者：
Micah, Angela E.;Su, Yanfang;Dieleman, Joseph L.
通讯作者：
Dieleman, Joseph L.
影响因子：
3.7
作者：
Aruhomukama, Dickson;Najjuka, Christine F.;Kateete, David P.
通讯作者：
Kateete, David P.
影响因子：
2.8
作者：
Albutt, Katherine;Punchak, Maria;Shrime, Mark G.
通讯作者：
Shrime, Mark G.
影响因子：
1.8
作者：
Manyahi, Joel;Matee, Mecky I;Lyamuya, Eligius F
通讯作者：
Lyamuya, Eligius F