伊朗住院患者支气管肺泡灌洗液样本的微生物学和耐药模式

IF 1.7 Q3 INFECTIOUS DISEASES
GERMS Pub Date : 2022-09-01 DOI:10.18683/germs.2022.1337
Zahra Tahmasebi, Parisa Asadollahi, Nourkhoda Sadeghifard, Sobhan Ghafourian, Behrooz Sadeghi Kalani, Esmail Ghasemi Pasha Kalaei, Iraj Pakzad
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引用次数: 0

摘要

简介:肺部疾病是世界范围内过早死亡和痛苦疾病的最常见原因之一。本研究的目的是检测支气管肺泡灌洗(BAL)标本中常见的感染性病原体及其耐药模式。方法:对伊朗伊拉姆市2所教学医院住院的呼吸系统疾病患者进行支气管镜检查,共收集44例BAL样本。将样品置于常规细菌培养基上培养,鉴定病原菌并计算菌落计数。按照CLSI规程,采用纸片扩散法测定药敏。采用16srRNA特异性引物PCR检测挑剔菌肺炎支原体和肺炎衣原体,mip特异性引物PCR检测嗜肺军团菌。结果:从44份BAL样品中共分离出100株细菌,包括:金黄色葡萄球菌(24,31.2%)、化脓性链球菌(18,23.4%)、肠球菌(11,14.3%)、鲍曼不动杆菌(11,14.3%)、铜绿假单胞菌(11,14.3%)、肠球菌(10,13%)、微球菌(5,6.5%)、表皮葡萄球菌(5,6.5%)和肺炎克雷伯菌(5,6.5%)。PCR检出肺炎衣原体阳性4例(9.1%),肺炎支原体和嗜肺军团菌无阳性。鲍曼不动杆菌对氨曲南和头孢他啶的耐药率最高(81.8%)。75%的金黄色葡萄球菌对头孢西丁(MRSA)耐药,83.3%的金黄色葡萄球菌具有mecA基因。27.3%的肠球菌(VRE)对万古霉素耐药。铜绿假单胞菌对哌拉西林、头孢噻肟、环丙沙星和亚胺培南的耐药率分别为54.5%、45.5%和36.4%。ICU分离出的微生物频率(46%)高于其他病房。结论:MRSA、耐头孢菌素肠杆菌科、耐哌拉西林、耐亚胺培南、耐头孢噻肟、耐氨曲南、耐环丙沙星的铜绿假单胞菌和鲍曼不动杆菌在不同病房,特别是ICU病房的存在是一个重要的卫生保健问题,需要明智地审查抗生素耐药感染的预防策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Microbiological and drug resistance patterns of bronchoalveolar lavage samples taken from hospitalized patients in Iran.

Introduction: Pulmonary diseases are amongst the most common causes of premature death and distressing disorders worldwide. This study aimed to detect the fastidious and routine infectious agents, and their drug resistance patterns in bronchoalveolar lavage (BAL) samples.

Methods: A total of 44 BAL samples were collected by bronchoscopy from patients with respiratory disorders hospitalized at 2 teaching hospitals in Ilam, Iran. The samples were cultured on routine bacterial culture media to identify the bacterial agents and calculate the colony count. Antibiotic susceptibility was determined by disk diffusion method according to the CLSI protocol. PCR was used to detect the fastidious bacteria Mycoplasma pneumoniae and Chlamydia pneumoniae using the 16srRNA specific primers and Legionella pneumophila using the mip specific primers.

Results: Overall, 100 bacterial isolates were isolated by culture from the 44 BAL samples including: Staphylococcus aureus (24, 31.2%), Streptococcus pyogenes (18, 23.4%), Enterococcus spp. (11, 14.3%), Acinetobacter baumannii (11, 14.3%), Pseudomonas aeruginosa (11, 14.3%), Enterococcus spp. (10, 13%), Micrococcus spp. (5, 6.5%), Staphylococcus epidermidis (5, 6.5%) and Klebsiella pneumoniae (5, 6.5%). PCR detected 4 positive samples (9.1%) for Chlamydia pneumoniae but no positive cases for Mycoplasma pneumoniae and Legionella pneumophila. Acinetobacter baumannii showed the highest resistance rate (81.8%) to aztreonam and ceftazidime. Seventy-five percent of the Staphylococcus aureus isolates were resistant to cefoxitin (MRSA) and 83.3% had the mecA gene. Vancomycin resistance was observed in 27.3% of the Enterococcus species (VRE). Resistance to piperacillin, cefotaxime, ciprofloxacin and imipenem was observed in 54.5%, 45.5%, and 36.4% of the Pseudomonas aeruginosa isolates, respectively. The frequency of organisms isolated from the ICU was higher (46%) than from other wards.

Conclusions: The presence of MRSA, cephalosporins-resistant Enterobacteriaceae as well as Pseudomonas aeruginosa and Acinetobacter baumannii resistant against piperacillin, imipenem, cefotaxime, aztreonam and ciprofloxacin amongst different wards, especially the ICU ward of the surveyed hospitals, is a major healthcare concern and it is necessary to wisely scrutinize the preventive strategies for antibiotic resistant infections.

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GERMS
GERMS INFECTIOUS DISEASES-
CiteScore
2.80
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