Đánh giá tình trạng kháng thuốc kháng sinh của các vi khuẩn gây nhiễm khuẩn huyết tại Bệnh viện Đa khoa tỉnh Ninh Thuận=Assessment of antibiotic resistance in bacteria causing bloodstream infections at Ninh Thuan Province General Hospital

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Tác giả: Thị Lý Đào, Huy Thạch Lê, Quốc Thắng Lê, Thị Hoa Lê, Vĩnh Nghi Nguyễn, Ánh Tuyết Trần, Gia Liêm Trương, Văn Hội Trương, Duy Hưng Võ

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.28-35

Bộ sưu tập: Metadata

ID: 478179

Thêm vào giỏ

Đánh giá tình trạng kháng thuốc kháng sinh của các vi khuẩn gây nhiễm khuẩn huyết nhằm cung cấp thêm căn cứ để bác sĩ lâm sàng tại Bệnh viện Đa khoa tỉnh Ninh Thuận lựa chọn kháng sinh trong bối cảnh tình trạng kháng thuốc kháng sinh đang gia tăng hiện nay. Phương pháp: Mô tả cắt ngang, hồi cứu tất cả các kết quả cấy máu dương tính với các vi khuẩn được định danh và làm kháng sinh đồ của Khoa Hóa sinh-Vi sinh, Bệnh viện Đa khoa tỉnh Ninh Thuận từ 01/10/2019 đến 15/9/2024. Kết quả: Trong thời gian nghiên cứu, có 2.631 bệnh phẩm máu gửi nuôi cấy, trong đó có 165 mẫu bệnh phẩm máu có vi khuẩn gây nhiễm khuẩn huyết (6,3%), tác nhân gây nhiễm khuẩn huyết được được xác định bằng cấy máu thường gặp là vi khuẩn Gram âm 51,5%, vi khuẩn Gram dương chiếm 48,5%. Vi khuẩn Staphylococcus aureus thường gặp nhất (35,2%), kế đến là Escherichia coli (15,2%), Staphylococcus coagulase âm tính (9,7%) và Klebsiella pneumoniae (7,9%),… Các chủng vi khuẩn này đã kháng với nhiều loại kháng sinh với các mức độ khác nhau khiến cho việc điều trị gặp khó khăn. Escherichia coli còn nhạy cảm cao nhất với imipenem, meropenem, netilmicine, piperacillin/ tazobactam, amikacine, amox/clav.ac, cefoxitin và cefuroxime. Klebsiella pneumoniae còn nhạy cảm cao nhất với amikacin, amox/clav.ac, cefoxitin, cefuroxime, ciprofloxacin, doxycycline, gentamicin, levofloxacin, netilmicine và tetracycline. Staphylococcus aureus vẫn còn nhạy cảm cao với chloramphenicol, vancomycin, tobramycin, và trime/sulfame. Kết luận: Nghiên cứu cho thấy sự cần thiết của việc theo dõi liên tục và có hệ thống các căn nguyên gây nhiễm khuẩn huyết và khảo sát mức độ đề kháng kháng sinh của các chủng vi khuẩn từ đó giúp các bác sỹ lâm sàng có được phác đồ điều trị kháng sinh theo kinh nghiệm trước khi có kết quả kháng sinh đồ cũng như giảm thiểu sự lan truyền các chủng vi khuẩn kháng kháng sinh.Evaluation of the antibiotic resistance status of bacteria causing sepsis to provide additional basis for clinicians at Ninh Thuan General Hospital to choose antibiotics in the context of increasing antibiotic resistance today. Method: Cross-sectional, retrospective description of all positive blood culture results with identified bacteria and antibiotic susceptibility testing of the Department of Biochemistry - Microbiology, Ninh Thuan Provincial General Hospital from October 1, 2019 to September 15, 2024. Results: During the study period, 2,631 blood specimens were sent for culture, of which 165 blood specimens contained bacteria causing sepsis (6.3%). The most common pathogens causing sepsis identified by blood culture were Gram-negative bacteria (51.5%), and Grampositive bacteria (48.5%). Staphylococcus aureus was the most common (35.2%), followed by Escherichia coli (15.2%), Staphylococcus coagulase negative (9.7%), and Klebsiella pneumoniae (7.9%), etc. These bacterial strains were resistant to many antibiotics at different levels, making treatment difficult. Escherichia coli was also most sensitive to imipenem, meropenem, netilmicine, piperacillin/tazobactam, amikacine, amox/clav.ac, cefoxitin, and cefuroxime. Klebsiella pneumoniae remained most susceptible to amikacin, amox/clav.ac, cefoxitin, cefuroxime, ciprofloxacin, doxycycline, gentamicin, levofloxacin, netilmicine, and tetracycline. Staphylococcus aureus remained highly susceptible to chloramphenicol, vancomycin, tobramycin, and trime/sulfame. Conclusion: The study shows the need for continuous and systematic monitoring of the causes of sepsis and surveying their antibiotic resistance levels, thereby helping clinicians to have empirical antibiotic treatment regimens before the results of antibiotic susceptibility testing are available as well as minimizing the spread of antibiotic-resistant bacterial strains.

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