PDF(Pubmed)
Abstract：
Antimicrobial resistance (AMR) is a public health problem threatening human, animal, and environmental safety. This study assessed the AMR profiles and risk factors associated with Escherichia coli in hospital and environmental settings in Lusaka, Zambia. This cross-sectional study was conducted from April 2022 to August 2022 using 980 samples collected from clinical and environmental settings. Antimicrobial susceptibility testing was conducted using BD PhoenixTM 100. The data were analysed using SPSS version 26.0. Of the 980 samples, 51% were from environmental sources. Overall, 64.5% of the samples tested positive for E. coli, of which 52.5% were from clinical sources. Additionally, 31.8% were ESBL, of which 70.1% were clinical isolates. Of the 632 isolates, 48.3% were MDR. Most clinical isolates were resistant to ampicillin (83.4%), sulfamethoxazole/trimethoprim (73.8%), and ciprofloxacin (65.7%) while all environmental isolates were resistant to sulfamethoxazole/trimethoprim (100%) and some were resistant to levofloxacin (30.6%). The drivers of MDR in the tested isolates included pus (AOR = 4.6, CI: 1.9-11.3), male sex (AOR = 2.1, CI: 1.2-3.9), and water (AOR = 2.6, CI: 1.2-5.8). This study found that E. coli isolates were resistant to common antibiotics used in humans. The presence of MDR isolates is a public health concern and calls for vigorous infection prevention measures and surveillance to reduce AMR and its burdens.
摘要：
抗菌素耐药性(AMR)是威胁人类健康的公共卫生问题,动物,和环境安全。这项研究评估了Lusaka医院和环境环境中与大肠杆菌相关的AMR概况和危险因素，赞比亚。这项横断面研究于2022年4月至2022年8月进行，使用从临床和环境环境中收集的980个样本。使用BDPhoenixTM100进行抗菌药敏感性测试。数据采用SPSS26.0版进行分析。980个样本中,51%来自环境来源。总的来说,64.5%的样本大肠杆菌检测呈阳性,其中52.5%来自临床。此外,31.8%是ESBL，其中70.1%为临床分离株。在632个分离物中,48.3％为MDR。大多数临床分离株对氨苄青霉素耐药(83.4%),磺胺甲恶唑/甲氧苄啶（73.8%），环丙沙星（65.7％），而所有环境分离株对磺胺甲恶唑/甲氧苄啶（100％）耐药，有些对左氧氟沙星耐药（30.6％）。受测分离株中MDR的驱动因素包括脓液（AOR=4.6，CI：1.9-11.3），男性（AOR=2.1，CI：1.2-3.9），和水（AOR=2.6，CI：1.2-5.8）。这项研究发现，大肠杆菌分离株对人类使用的常见抗生素具有抗性。MDR分离株的存在是一个公共卫生问题，需要采取强有力的感染预防措施和监测，以减少AMR及其负担。
