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Register a new userPrevalence of Extended Spectrum beta Lactamases (ESBL) in Escherichia coli in Al-Assad Teaching Hospital
دراسة انتشار أنظيم بيتا لاكتاماز الواسع الطيف عند جراثيم الاشرشيا القولونية في مشفى الأسد الجامعي
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Authors
زين ابراهيم بعيتي( طالب )
Created by
Zain Baaity
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أجريت هذه الدراسة في مشفى الأسد الجامعي في اللاذقية، حيث تم جمع 236 عينة اشرشيا قولونية متنوعة مأخوذة من 6 مواضع (بولية، دموية، تناسلية، جراحية، قثطرة، مفجر) وتم اجراء اختبارات التحري عن وجود انزيمات البيتا لاكتاماز واسع الطيف وفقاً لآخر التوصيات الحديثة، حيث اتبعت طرق مرجعية دقيقة تقارب حساسيتها ونوعيتها 99%. بلغ عدد العينات المقاومة 75 عينة أي 32% من العدد الكلي وبعد اجراء اختبار التحري عن ESBL الذي كان ايجابياً على 62 عينة 26% من العينات الكلية، وأبدت 13عينة فقط مقاومة جرثومية غير ESBL.
Two hundred and thirty-six E. coli isolates n=236 were collected. Antibiotic susceptibility and ESBL production were studied by disc diffusion and DDST (double disk synergy tests) according to Clinical Laboratory Standards Institute guidelines (CLSI) and EUCAST for ESBL. 75 (32%)of total isolates demonstrated MDR (multi drug resistance),62 of resistant bacteria (26% of total) were determined as ESBL producers. In conclusion, we recommend adding this standard, cheap ESBL detection method to the routine microbial susceptibility tests run in Syrian hospitals in order to determine and isolate the sources of MDR infections and do some effort to contain and eliminate those strains.
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Research summary
تهدف هذه الدراسة إلى تحديد مدى انتشار إنتاج إنزيمات البيتا-لاكتاماز واسعة الطيف (ESBL) في عزلات الإشريكية القولونية (E. coli) من مرضى في مستشفى الأسد التعليمي خلال الأزمة السورية. تم جمع 236 عينة من الإشريكية القولونية من مصادر مختلفة مثل البول والدم ومسحات الجروح وغيرها. أظهرت النتائج أن 32% من العزلات كانت مقاومة للمضادات الحيوية من الجيل الثالث للسيفالوسبورينات، و26% منها كانت منتجة لإنزيمات ESBL. تم استخدام اختبارات الانتشار القرصي واختبار التآزر المزدوج (DDST) لتحديد حساسية المضادات الحيوية وإنتاج ESBL. أظهرت الدراسة أن معظم العزلات المقاومة جاءت من مسحات الجروح والقسطرة، مما يشير إلى أن العدوى كانت غالبًا مستشفوية. توصي الدراسة بإضافة اختبار ESBL إلى الاختبارات الروتينية في المستشفيات السورية للحد من انتشار العدوى المقاومة للمضادات الحيوية.
Critical review
دراسة نقدية: تعتبر هذه الدراسة مهمة جدًا لفهم مدى انتشار المقاومة للمضادات الحيوية في سوريا، خاصة في ظل الأزمة الحالية. ومع ذلك، يمكن تحسين الدراسة من خلال توسيع نطاق العينة لتشمل مستشفيات ومناطق أخرى في سوريا للحصول على صورة أكثر شمولية. كما أن الدراسة تعتمد بشكل كبير على اختبارات الانتشار القرصي واختبار التآزر المزدوج، والتي قد تكون غير كافية للكشف عن جميع أنواع المقاومة. يمكن تعزيز النتائج من خلال استخدام تقنيات أكثر تقدمًا مثل تفاعل البوليميراز المتسلسل (PCR) لتحديد الجينات المسؤولة عن المقاومة.
Questions related to the research
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ما هو الهدف الرئيسي من هذه الدراسة؟
الهدف الرئيسي هو تحديد مدى انتشار إنتاج إنزيمات البيتا-لاكتاماز واسعة الطيف (ESBL) في عزلات الإشريكية القولونية من مرضى في مستشفى الأسد التعليمي خلال الأزمة السورية.
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ما هي نسبة العزلات التي أظهرت مقاومة للمضادات الحيوية من الجيل الثالث للسيفالوسبورينات؟
32% من العزلات أظهرت مقاومة للمضادات الحيوية من الجيل الثالث للسيفالوسبورينات.
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ما هي المصادر الرئيسية للعزلات المقاومة في هذه الدراسة؟
المصادر الرئيسية للعزلات المقاومة كانت مسحات الجروح والقسطرة.
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ما هي التوصيات التي قدمتها الدراسة للحد من انتشار العدوى المقاومة للمضادات الحيوية؟
توصي الدراسة بإضافة اختبار ESBL إلى الاختبارات الروتينية في المستشفيات السورية واستخدام تقنيات مثل تفاعل البوليميراز المتسلسل (PCR) لتحديد الجينات المسؤولة عن المقاومة.
References used
Jarlier ,et al
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Introduction: As nursing develop with regard to science, knowledge & practice and nursing responsibilities increase, critical thinking- the ability to question and make rational decisions- becomes even more important. Whereas, critical thinking requi
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