Antibiotic resistance pattern of multidrug-resistant Enterobacterales from a rectal surveillance study in northern Nigeria.

IF 2.3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Yahaya Yaqub, Joan Ejembi, Aliyu Aminu, Zainab Rabilu Daninna, Zainab Lamido Tanko, Nasiru Usman Ibrahim, Oduma Audu, Bawa Ega
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引用次数: 0

Abstract

Background: Multidrug-resistant organisms (MDROs) are important in clinical practice worldwide. As whole genome sequencing (WGS) technologies are adopted, it is key to understand the nature of MDROs before the introduction of WGS in resource-poor settings.

Methods: A hospital-based surveillance study was conducted in the largest referral health facility in northern Nigeria. A rectal swab sample was collected from each patient and samples were investigated for extended spectrum beta-lactamases and carbapenemase-resistant Enterobacterales (i.e. ESBL-PE and CRE, respectively). These MDROs were subjected to antimicrobial susceptibility testing and multiplex PCR. Statistical analyses were used to identify any associations between MDROs and selected antibiotics.

Results: The prevalence of MDROs among participants (N=168) was 87.5% (n=147) for ESBL-PE and 4.2% (n=7) for CRE. All isolates were resistant to tetracycline and co-trimoxazole; however, most MDROs were susceptible to meropenem, ceftazidime-avibactam and fosfomycin (≥70%). blaSHV (33.3%; n=49) was the predominant ESBL gene carried by the isolates, followed by combinations of blaSHV, blaCTX and blaTEM. Although no carbapenemase genes were found, all CRE isolates had the blaOXA-48 gene, which may not be associated with phenotypic carbapenem resistance observed (χ2=0.056, p=0.81).

Conclusions: Research utilising WGS and bioinformatics will elucidate more of the molecular landscape of MDROs in resource-poor settings.

背景:耐多药生物(MDROs)在全世界的临床实践中都很重要。随着全基因组测序(WGS)技术的采用,在资源匮乏的环境中引入 WGS 之前,了解 MDRO 的性质至关重要:方法:在尼日利亚北部最大的转诊医疗机构开展了一项基于医院的监测研究。方法:在尼日利亚北部最大的转诊医疗机构开展了一项以医院为基础的监测研究,收集了每位患者的直肠拭子样本,并对样本进行了广谱β-内酰胺酶和碳青霉烯酶耐药肠杆菌(分别为 ESBL-PE 和 CRE)的检测。对这些 MDRO 进行了抗菌药敏感性检测和多重 PCR 检测。统计分析用于确定 MDRO 与选定抗生素之间的关联:结果:MDROs在参与者(168人)中的流行率为:ESBL-PE为87.5%(147人),CRE为4.2%(7人)。所有分离株都对四环素和共三唑有耐药性,但大多数 MDRO 对美罗培南、头孢唑肟-阿维巴坦和磷霉素(≥70%)敏感。虽然没有发现碳青霉烯酶基因,但所有 CRE 分离物都带有 blaOXA-48 基因,这可能与观察到的表型碳青霉烯耐药性无关(χ2=0.056,p=0.81):结论:利用 WGS 和生物信息学进行的研究将进一步阐明资源贫乏地区 MDROs 的分子状况。
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来源期刊
International Health
International Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
4.50
自引率
0.00%
发文量
83
审稿时长
>12 weeks
期刊介绍: International Health is an official journal of the Royal Society of Tropical Medicine and Hygiene. It publishes original, peer-reviewed articles and reviews on all aspects of global health including the social and economic aspects of communicable and non-communicable diseases, health systems research, policy and implementation, and the evaluation of disease control programmes and healthcare delivery solutions. It aims to stimulate scientific and policy debate and provide a forum for analysis and opinion sharing for individuals and organisations engaged in all areas of global health.
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