Đặc điểm phân bố lâm sàng của Escherichia coli kháng carbapenem phân lập tại Bệnh viện Hữu Nghị Đa khoa Nghệ An=Clinical distribution characteristics of carbapenem-resistant escherichia coli strains in Nghe An Friendship General Hospital

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Tác giả: Việt Anh Đậu, Thị An Hà Hoàng, Võ Dũng Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.418-426

Bộ sưu tập: Metadata

ID: 478068

Thêm vào giỏ

Khảo sát đặc điểm phân bố lâm sàng của các chủng Escherichia coli kháng carbapenem (CREC) tại Bệnh viện Hữu nghị Đa khoa Nghệ An từ tháng 11 năm 2023 đến tháng 4 năm 2024, trên cơ sở đó cung cấp dữ liệu để xây dựng các biện pháp hạn chế lây lan loại vi khuẩn này. Đối tượng, phương pháp nghiên cứu: Mô tả cắt ngang trên 524 chủng E. coli phân lập được từ các loại bệnh phẩm lâm sàng. Kết quả: Xác định được 41 chủng E. coli kháng và 1 chủng kháng trung gian carbapenem, chiếm tỷ lệ lần lượt là 7,8% và 0,2%. Đờm là bệnh phẩm có tỷ lệ phân lập được CREC cao nhất (16,7%), tiếp đó là các chủng từ nước tiểu (8,6%). CREC phân bố rải rác ở nhiều khoa lâm sàng trong toàn viện, tuy nhiên, các khoa Hồi sức (Hồi sức tích cực, Hồi sức chống độc, Hồi sức nhiễm khuẩn) và khoa Chống độc là những “điểm nóng” của CREC. Tỷ lệ CREC phân lập ở các khoa này cao hơn các khoa lâm sàng hệ nội (Nội A, nội tiêu hóa, Nội tổng hợp, Nội tim mạch, Bệnh nhiệt đới, ...) với sự khác biệt có ý nghĩa thống kê (p <
0,05). Không có mối liên quan giữa độ tuổi, giới tính, nơi cư trú với sự xuất hiện của CREC. Kết luận: CREC thường có mặt trong bệnh phẩm đờm, nước tiểu, máu, phân bố nhiều tại khoa Chống độc và các khoa Hồi sức. Do đó, cần tăng cường các biện pháp kiểm soát nhiễm khuẩn tại các khoa này nhằm tránh lây lan CREC giữa bệnh nhân với bệnh nhân, bệnh nhân với môi trường khoa phòng cũng như quản lý, xử lý tốt bệnh phẩm để tiêu diệt vi khuẩn đề kháng, hạn chế sự phát tán các CREC và các gen đề kháng.To explore the clinical distribution characteristics of carbapenemresistant Escherichia coli (CREC) in Nghe An Friendship General Hospital, from November 2023 to April 2019 to provide the database for developing measures to prevent the spread of CREC. Subjects and Methods: A crosssectional descriptive 524 E. coli strains were isolated. Results: We identified 41 carbapenemresistant Escherichia coli strains and 1 strain with intermediate resistance to carbapenems, representing rates of 7.8% and 0.2%, respectively. Sputum samples had the highest rate of carbapenem-resistant E. coli isolation (16.7%), followed by urine samples (8.6%). CREC was distributed across various clinical departments throughout the hospital
however, the departments of Intensive Care (Intensive Care Unit, Intensive Care for Toxicology, and Infectious Disease Intensive Care) and the Toxicology Department were identified as "hotspots" for CREC. The rate of CREC isolation in these departments was significantly higher than in internal medicine departments (Internal Medicine A, Gastroenterology, General Internal Medicine, Cardiology, Tropical Diseases, etc.) with statistically significant differences (p <
0.05). There was no correlation between age, sex, or residence with the presence of CREC. Conclusion: CREC is commonly found in sputum and urine specimens, with significant distribution in the Intensive Care and Toxicology departments. Therefore, it is necessary to enhance infection control measures in these departments to prevent the spread of CREC among patients, between patients and the hospital environment, and to pay special attention to proper handling of sputum, urine, blood to eliminate resistant bacteria, limit the spread of CREC strains and their resistant genes.

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