Prevalence of MDR bacteria in an acute trauma hospital in Port-au-Prince, Haiti: a retrospective analysis from 2012 to 2018.
Prevalence of MDR bacteria in an acute trauma hospital in Port-au-Prince, Haiti: a retrospective analysis from 2012 to 2018.
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DOI：
10.1093/jacamr/dlab140
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发表时间：
2021-09
影响因子：
3.4
通讯作者：
Mahama G
中科院分区：
文献类型：
--
作者：
Açma A;Williams A;Repetto E;Cabral S;Sunyoto T;Woolley SC;Mahama G
抗生素耐药性（ABR）被认为是对全球健康日益严重的威胁。海地于2018年宣布ABR为新出现的公共卫生威胁，然而，目前的监测系统有限。我们描述了来自无国界医生组织创伤医院的微生物数据，以增加对海地类似设施的ABR的了解。回顾性横断面分析2012年3月至2018年12月创伤医院住院或门诊随访患者的常规微生物数据。分析了每个分离株的耐药趋势，并比较了7年期间的耐药趋势。1742株分离物中，脓液（53.4%）、伤口拭子（30.5%）和血液（6.9%）最为常见。检出最多的细菌为金黄色葡萄球菌（21.9%）、铜绿假单胞菌（20.9%）和肺炎克雷伯菌（16.7%）。检测到耐多药菌（32.0%）、产esbl菌（39.1%）、MRSA菌（24.1%）和耐碳青霉烯肠杆菌科（CRE）菌（2.6%）。2012年至2018年，ESBL分离株数量从3.2%显著上升至42.9% (P = 0.0001)， MSSA分离株对克林霉素的耐药性从3.7%上升至29.6% （P = 0.003）。还检测到两种世卫组织重点关注的关键病原体（产生esbl的CRE和耐碳青霉烯假单胞菌）。在7年的时间里，MDR细菌的流行率很高，而产生esbl的细菌呈显著增加趋势。ABR监测对临床决策、治疗指南和感染预防和控制实践具有重要意义。
Antibiotic resistance (ABR) is recognized as an increasing threat to global health. Haiti declared ABR an emerging public health threat in 2018, however, the current surveillance system is limited. We described the microbiological data from a Médecins Sans Frontières trauma hospital, to increase knowledge on ABR in Haiti for similar facilities. A retrospective cross-sectional analysis of routine microbiological data of samples taken from patients admitted to the inpatient ward or followed up in the outpatient clinic of the trauma hospital from March 2012 to December 2018. Resistance trends were analysed per isolate and compared over the 7 year period. Among 1742 isolates, the most common samples were pus (53.4%), wound swabs (30.5%) and blood (6.9%). The most frequently detected bacteria from these sample types were Staphylococcus aureus (21.9%), Pseudomonas aeruginosa (20.9%) and Klebsiella pneumoniae (16.7%). MDR bacteria (32.0%), ESBL-producing bacteria (39.1%), MRSA (24.1%) and carbapenem-resistant Enterobacteriaceae (CRE) species (2.6%) were all detected. Between 2012 and 2018 the number of ESBL isolates significantly increased from 3.2% to 42.9% (P = 0.0001), and resistance to clindamycin in MSSA isolates rose from 3.7% to 29.6% (P = 0.003). Two critical WHO priority pathogens (ESBL-producing CRE and carbapenem-resistant P. aeruginosa) were also detected. Over a 7 year period, a high prevalence of MDR bacteria was observed, while ESBL-producing bacteria showed a significantly increasing trend. ABR surveillance is important to inform clinical decisions, treatment guidelines and infection prevention and control practices.