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首页> 外文期刊>American Journal of Epidemiology and Infectious Disease >Beta-lactamase Producing Bacteria in Community and Hospital Setting in Riyadh: Occurrence, and Susceptibility to Antibiotics
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Beta-lactamase Producing Bacteria in Community and Hospital Setting in Riyadh: Occurrence, and Susceptibility to Antibiotics

机译：利雅得在社区和医院中的β-内酰胺酶生产细菌：发生和对抗生素的敏感性。

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Background: Extended-spectrum β-lactamase producing bacteria (ESBL) poses an increasing challenge to both public health and hospital infection control services. Objective: To determine the prevalence of ESBL producing bacteria, types of infection they cause and their susceptibility patterns to antibiotics in hospital and community settings. Settings and Design: This is a cross-sectional study that was conducted at a Medical City in Riyadh. Methods: All clinical specimens with positive culture for Gram-negative bacteria were collected from the microbiology laboratory for the year 2013. When bacteria are identified as ESBL strain, the antimicrobial susceptibility is analyzed. Demographic data were collected from patients’ records. Results: Overall, 763/6993 (10.9%) were ESBL producing strains from all gram negative bacteria. The highest detection of ESBL bacteria were from specimens of patients over sixty years (34.2%), and 23.7% were from 0-<15 year old. The most frequently detected bacteria was E.coli (76.5%) (Significantly higher among outpatients 54.5%) with highest detection from urine, skin swab, blood, wound and ulcer specimens, followed by K .pneumonia (23.1%) (Significantly higher among inpatients 69.3%) with highest detection from respiratory specimens including sputum. The resistance pattern to antimicrobials was (75.5%, 81.3%) to trimethoprim/sulfamethoxazole, (69.7%, 42.6%) to ciprofloxacin, (38.9%, 58.5%) to gentamicin and (8.7%, 30.7) to piperacillin/tazobactam (E.coli, K. pneumonia respectively). However, very high sensitivity to imipenem and meropenem was reported for both bacteria. Generally, ESBL bacteria isolated from outpatients showed significantly higher resistance to ciprofloxacin than the isolates from inpatients (p=0.02), conversely is detected with piperacillin/tazobactam (p<0.0001). Conclusion: Currently, carbapenems and amikacin are the first line antibiotics that can be used for the treatment of ESBL bacterial infections in both settings. Since ESBL bacterial resistance pattern is increasing, periodical monitoring of antimicrobial susceptibility of isolated ESBL bacteria, and rotating the use of the effective antimicrobial drugs according to guidelines of antimicrobial stewardship programs should always be considered.
机译：背景：产生超广谱β-内酰胺酶的细菌（ESBL）对公共卫生和医院感染控制服务构成越来越大的挑战。目的：确定在医院和社区环境中产生ESBL的细菌的流行情况，它们引起的感染类型以及对抗生素的敏感性模式。设置和设计：这是在利雅得医疗城进行的一项横断面研究。方法：2013年从微生物学实验室收集所有革兰氏阴性菌阳性培养的临床标本。当细菌被鉴定为ESBL菌株时，分析其药敏性。从患者记录中收集人口统计数据。结果：总共有763/6993（10.9％）产自所有革兰氏阴性细菌的ESBL菌株。 ESBL细菌检出率最高的是60岁以上患者的样本（占34.2％），23.7％的样本是0- <15岁。检出率最高的细菌是大肠杆菌（76.5％）（门诊患者中显着高于54.5％），从尿液，皮肤拭子，血液，伤口和溃疡标本中检出率最高，其次是肺炎K.（23.1％）（其中住院患者中占69.3％），其中包括痰在内的呼吸道标本的检出率最高。抗菌剂对甲氧苄啶/磺胺甲恶唑的抗药性为（75.5％，81.3％），对环丙沙星的抗药性为（69.7％，42.6％），对庆大霉素的抗药性为（38.9％，58.5％），对哌拉西林/他唑巴坦（E的抗药性为（8.7％，30.7） .coli，肺炎克雷伯氏菌）。但是，据报道两种细菌对亚胺培南和美洛培南的敏感性都很高。通常，从门诊病人中分离出的ESBL细菌对环丙沙星的耐药性要比从住院病人中分离出的细菌（p = 0.02）高，相反，用哌拉西林/他唑巴坦检测到（p <0.0001）。结论：目前，碳青霉烯类和丁胺卡那霉素是在两种环境下均可用于治疗ESBL细菌感染的一线抗生素。由于ESBL细菌的耐药性正在增加，因此应始终考虑定期监测分离出的ESBL细菌的药敏性，并根据抗菌素管理计划的指南轮换使用有效的抗菌药。

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