Using an Antibiogram Profile to Improve Infection Control and Rational Antimicrobial Therapy in an Urban Hospital in The Gambia, Strategies and Lessons for Low- and Middle-Income Countries.
Using an Antibiogram Profile to Improve Infection Control and Rational Antimicrobial Therapy in an Urban Hospital in The Gambia, Strategies and Lessons for Low- and Middle-Income Countries.
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利用抗体图概况来改善冈比亚城市医院的感染控制和合理的抗菌治疗，低收入和中等收入国家的策略和课程。
DOI：
10.3390/antibiotics12040790
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发表时间：
2023-04-21
影响因子：
4.8
通讯作者：
Garner, Omai B.
中科院分区：
文献类型：
--
作者：
Darboe, Saffiatou;Mirasol, Ruel;Adejuyigbe, Babapelumi;Muhammad, Abdul Khalie;Nadjm, Behzad;De St. Maurice, Annabelle;Dogan, Tiffany L.;Ceesay, Buntung;Umukoro, Solomon;Okomo, Uduak;Nwakanma, Davis;Roca, Anna;Secka, Ousman;Forrest, Karen;Garner, Omai B.
关键词：
抗菌素耐药性是一个全球性的健康威胁，有必要努力减轻它，因此需要本地抗菌谱来改善管理。这项研究重点介绍了用于开发抗菌谱以监测二级卫生机构耐药性的过程，以帮助撒哈拉以南非洲国家的经验性临床决策。这项回顾性横断面描述性研究使用了 2016 年 1 月至 2018 年 12 月 3 年的累积数据。表型数据手动输入 WHONET，并根据 CLSI M39-A4 指南使用标准化方法构建累积抗菌谱。通过标准手动微生物学方法鉴定病原体，并根据 CLSI M100 指南使用 Kirby-Bauer 纸片扩散法进行抗菌药物敏感性测试。总共处理了 14,776 个非重复样本，其中 1163 个（7.9%）呈临床显着病原体阳性。在 1163 种病原体中，大肠杆菌 (n = 315)、金黄色葡萄球菌 (n = 232) 和肺炎克雷伯菌 (n = 96) 是导致疾病的主要原因。总体而言，所有样本对大肠杆菌和肺炎克雷伯菌的敏感性为：甲氧苄啶-磺胺甲恶唑（17% 和 28%）、四环素（26% 和 33%）、庆大霉素（72% 和 46%）、氯霉素（76% 和 60%）、环丙沙星（69% 和 59%），以及 阿莫西林/克拉维酸（分别为 77% 和 54%）。超广谱 β-内酰胺酶 (ESBL) 耐药率分别为 23% (71/315) 和 35% (34/96)。金黄色葡萄球菌对甲氧西林的敏感性为99%。该抗菌谱表明冈比亚有必要改进联合治疗。
Antimicrobial resistance is a global health threat and efforts to mitigate it is warranted, thus the need for local antibiograms to improve stewardship. This study highlights the process that was used to develop an antibiogram to monitor resistance at a secondary-level health facility to aid empirical clinical decision making in a sub-Saharan African county. This retrospective cross-sectional descriptive study used 3 years of cumulative data from January 2016 to December 2018. Phenotypic data was manually imputed into WHONET and the cumulative antibiogram constructed using standardized methodologies according to CLSI M39-A4 guidelines. Pathogens were identified by standard manual microbiological methods and antimicrobial susceptibility testing was performed using Kirby-Bauer disc diffusion method according to CLSI M100 guidelines. A total of 14,776 non-duplicate samples were processed of which 1163 (7.9%) were positive for clinically significant pathogens. Among the 1163 pathogens, E. coli (n = 315) S. aureus (n = 232), and K. pneumoniae (n = 96) were the leading cause of disease. Overall, the susceptibility for E. coli and K. pneumoniae from all samples were: trimethoprim-sulfamethoxazole (17% and 28%), tetracycline (26% and 33%), gentamicin (72% and 46%), chloramphenicol (76 and 60%), and ciprofloxacin (69% and 59%), and amoxicillin/clavulanic (77% and 54%) respectively. Extended spectrum beta-lactamase (ESBL) resistance was present in 23% (71/315) vs. 35% (34/96) respectively. S. aureus susceptibility for methicillin was 99%. This antibiogram has shown that improvement in combination therapy is warranted in The Gambia.
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影响因子：
3.8
作者：
Armitage, Edwin P.;Senghore, Elina;de Silva, Thushan I.
通讯作者：
de Silva, Thushan I.
影响因子：
1.6
作者：
Erdem I;Kara Ali R;Ardic E;Elbasan Omar S;Mutlu R;Topkaya AE
通讯作者：
Topkaya AE
影响因子：
3.9
作者：
Darboe, Saffiatou;Bradbury, Richard S.;Phelan, Jody;Kanteh, Abdoulie;Muhammad, Abdul-Khalie;Worwui, Archibald;Yang, Shangxin;Nwakanma, Davis;Perez-Sepulveda, Blanca;Kariuki, Samuel;Kwambana-Adams, Brenda;Antonio, Martin
通讯作者：
Antonio, Martin
影响因子：
5.7
作者：
Darboe, Saffiatou;Dobreniecki, Sarah;Secka, Ousman
通讯作者：
Secka, Ousman
影响因子：
3.7
作者：
Ceesay, Serign J.;Casals-Pascual, Climent;Conway, David J.
通讯作者：
Conway, David J.