الطرق التقليدية والجزيئية لتشخيص التهاب السحايا الجرثومي في مدينة أربيل ، العراق
محتوى المقالة الرئيسي
الملخص
يعد التهاب السحايا البكتيرى سبباً رئيسيا للمرض السحايا والوفاة عالمياً، والتشخيص المبكر لمسببات التهاب السحايا في الوقت المناسب امر بالغ الاهمية للرعاية الصحية السريرية والعامة، وكذلك مكافحة المرض. خلال الفترة من كانون الثاني 2021 الى شباط 2022، تم جمع مائة نموذج من سائل دماغي الشوكي وعينة الدم من الحالات المشتبه اصابتها بالتهاب السحايا التي تم ادخالها الى مستشفى رابرين التعليمي للاطفال في مدينة اربيل، العراق. تم اجراء التحاليل المزرعية و البايوكيميائية وتم تصديقها بواسطة التقنيات الجزيئية. اظهرت النتائج المزرعية ان 7% من العينات السائل الدماغي الشوكي وواحدة في نماذج الدم كانت موجبة. اكثر مسببات الامرض شيوعا التي تم العثور عليها من خلال الخصائص المزرعية و استخدام نظام فايتك 2 كانت Stphylococcus sciuri لنموذجين 2% ، Staphylococcus xylosus في نموذج واحد 1% ، Escherichia coli في نموذجين 2% ،Enterococcus casseliflavus , Micrococcus luteus والتي تم تسجيلهما لأول مرة كمسبب لالتهاب السحايا في مدينة اربيل، العراق. جميع العزلات تم تصديقها بواسطة تقنية PCR .تم فحص جميع العزلات المرضية بحثا عن حساسية هذه العزلات لبعض المضادات الحيوية، اظهرت النتائج ان جميع العزلات كانت مقاومة للمضاد الحيوي ميروبينيم و توبرامايسين بنسبة 100%، في حين اظهرت عزلة E. coli مقاومتها بنسية 100% لكل من سيفوتاكسيم، جينتامايسين، بينيسيلين، سيفتريكسون، ريفامبيسين، اموكيسيلين/كلافولانك اسيد، سيفتازيديم، ايرثروميسين، امبيسيلين، وكلينداميسين الا انها كانت حساسة 100% لاميكاسين و اميبينيم، الا ان جميع عزلات الموجبة لصبغة غرام اظهرت مقاومتها و بنسية 100% لاوبتوجين و كانت حساسة 100% الجينتامايسين و تراميثوبريم. كما اوضحت النتائج ان في مرضى اتهاب السحايا الجرثومي تم ملاحظة ارتفاع كل من البروتين التفاعلي (>50 mg/dl) CRP وبروتين(>50 mg/dl)CSF وانخفاض في مستوى سكر الكلوكوزفي السائل الدماغي الشوكي(<40 mg/dl) و ارتفاع عدد الخلايا البيضاء (>100 cells/mm3) في السائل الشوكي.
Received 17/09/2022
Revised 02/01/2023
Accepted 04/01/2023
Published Online First 20/07/2023
تفاصيل المقالة
هذا العمل مرخص بموجب Creative Commons Attribution 4.0 International License.
كيفية الاقتباس
المراجع
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