伊朗转诊儿科医院革兰氏阴性菌的抗菌素耐药模式:新德里金属β-内酰胺酶的当前危险。

Q3 Pharmacology, Toxicology and Pharmaceutics
Shima Mahmoudi, Babak Pourakbari, Maryam Rostamyan, Hojatollah Raji, Reihaneh Hosseinpour Sadeghi, Setareh Mamishi
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引用次数: 0

摘要

背景:革兰氏阴性菌的抗微生物药物耐药性一直在增长,特别是在伊朗等发展中国家。碳青霉烯耐药机制的出现和传播是一个主要的公共卫生问题,因为目前还没有确定的治疗方法来解决这个问题。本研究旨在评估伊朗德黑兰儿童医疗中心转诊患者的革兰氏阴性菌、金属β-内酰胺酶(MBLs)和碳青霉烯酶产生基因(包括bla NDM、bla VIM和bla IMP)的抗生素敏感性。材料与方法:本横断面研究共检测革兰氏阴性菌株944株,并进行药敏试验。此外,还研究了碳青霉烯耐药菌株的MBL产量,以及bla NDM、bla VIM和bla IMP的存在。结果:最常见的革兰氏阴性分离菌为大肠埃希菌(489份,52%),其次为肺炎克雷伯菌(167份,18%)、铜绿假单胞菌(101份,11%)、肠杆菌(64份,7%)、假单胞菌(35份,4%)、鲍曼不动杆菌(18份,2%)、洋葱伯克氏菌(17份,2%)。嗜麦芽窄养单胞菌、肠杆菌和鲍曼不动杆菌分离株分别有75%、61%和60%对亚胺培南耐药。对美罗培南耐药率最高的菌种为嗜麦芽球菌(S. maltopophilia)、鲍曼杆菌(A. baumannii)、铜绿假单胞菌(P. aeruginosa)和洋葱球菌(B. cepacia),分别为100%、96%、83%和61.5%。双盘协同试验(DDST)结果显示,255株碳青霉烯类耐药菌株中有112株(44%)为产mbl菌株。在32株(29%)产生mbl的分离株中检测到bla NDM基因,其中肺炎克雷伯菌13株,铜绿假单胞菌7株,大肠杆菌7株,肠杆菌3株,克雷伯菌2株。bla IMP和bla VIM基因分别在2个(2%)和1个(1%)产生mbl的分离株中检测到。这些基因仅在产生mbl的铜绿假单胞菌分离株中检测到。结论:我院出现了产NDM的菌株,bla NDM是产NDM的铜绿假单胞菌、肺炎克雷伯菌中检出最多的碳青霉烯酶基因,该菌易在院内患者中传播,建议制定强有力的感染控制和预防方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Antimicrobial Resistance Patterns of Gram-negative Bacteria in an Iranian Referral Pediatric Hospital: A Present Danger of New Delhi Metallo-β- lactamase.

Background: Antimicrobial resistance among gram-negative bacteria has been growing, particularly in developing countries, like Iran. The emergence and spread of carbapenem-resistance mechanisms is a major public health concern because no definite treatments have yet been established for this problem. This study aimed to evaluate antibiotic susceptibility of gram-negative bacteria, metallo-β-lactamases (MBLs) and carbapenemase-producing genes, including bla NDM, bla VIM, and bla IMP in patients referred to Children's Medical Center, Tehran, Iran.

Material and methods: In this cross-sectional study, a total of 944 gram-negative isolates were tested in the study, and antimicrobial susceptibility testing was performed. Moreover, MBL production of carbapenem-resistant isolates, as well as the presence of bla NDM, bla VIM, and bla IMP, was investigated.

Results: The most common gram-negative isolated bacteria were Escherichia coli (489 samples, 52%), followed by Klebsiella pneumoniae (167 samples, 18%), Pseudomonas aeruginosa (101 samples, 11%), Enterobacter spp. (64 samples, 7%), Pseudomonas spp. (35 samples, 4%), Acinetobacter baumannii (18 samples, 2%), and Burkholderia cepacia (17 samples, 2%). Imipenemresistant was found in 75%, 61%, and 60% of Stenotrophomonas maltophilia, Enterobacter spp., and A. baumannii isolates, respectively. Moreover, the highest resistance to meropenem was observed in S. maltophilia, A. baumannii, P. aeruginosa, and B. cepacia (100%, 96%, 83%, and 61.5%, respectively). Double disk synergy test (DDST) results showed that 112 out of 255 carbapenem- resistant isolates (44%) were MBL-producing ones. The presence of the bla NDM gene was identified in 32 (29%) of MBL-producing isolates, 13 of which were K. pneumoniae, 7 P. aeruginosa, and 7 E. coli, 3 Enterobacter spp., and 2 Klebsiella spp., respectively. The presence of the bla IMP and bla VIM genes was detected in 2 (2%) and 1 (1%) of MBL-producing isolates. These genes were detected in only MBL-producing P. aeruginosa isolates.

Conclusion: Our findings suggest the emergence of NDM-producing strains in our hospital, and bla NDM was the most frequently detected carbapenemase gene in MBL-producing P. aeruginosa, K. pneumoniae, and Klebsiella spp. Since such bacteria can easily spread among patients in the hospital, a strong infection control and prevention plan is highly recommended.

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来源期刊
Infectious disorders drug targets
Infectious disorders drug targets Pharmacology, Toxicology and Pharmaceutics-Pharmacology
CiteScore
3.10
自引率
0.00%
发文量
123
期刊介绍: Infectious Disorders - Drug Targets aims to cover all the latest and outstanding developments on the medicinal chemistry, pharmacology, molecular biology, genomics and biochemistry of contemporary molecular targets involved in infectious disorders e.g. disease specific proteins, receptors, enzymes, genes. Each issue of the journal contains a series of timely in-depth reviews written by leaders in the field covering a range of current topics on drug targets involved in infectious disorders. As the discovery, identification, characterization and validation of novel human drug targets for anti-infective drug discovery continues to grow, this journal will be essential reading for all pharmaceutical scientists involved in drug discovery and development.
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