Blaoxa-1基因与肺炎克雷伯菌临床分离株多药耐药的关系

Aisha Gohar, Ihsan Ullah, None Abdullah, Taj Ali Khan
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摘要

目的:本研究旨在从患者样本中分离肺炎克雷伯菌,并发现质粒介导的bla-OXA-1基因与多药耐药肺炎克雷伯菌的关系。本横断面研究在白沙瓦的马尔丹医疗中心和开伯尔医科大学进行。通过培养从脓、尿、血样本中分离出肺炎克雷伯菌,并进行生化鉴定。根据CLSI 2022指南,通过椎间盘扩散进行抗生素敏感性测试。提取并扩增质粒DNA后,对该基因进行聚合酶链反应。此外,证实blaOXA-1与抗生素耐药有关。结果从患者标本中共培养出160株肺炎克雷伯菌,其中脓液(135株,84.37%)、尿液(15株,9.37%)和血液(10株,6.26%)。对青霉素- g耐药154株(96.3%),其次是头孢曲松151株(94.4%)、头孢吡肟143株(89.4%)、阿莫西林125株(78.1%)、替加环素110株(68.8%)、亚胺培南92株(57.6%)和厄他培南75株(49.9%)。然而,四环素有1.9%的耐药性。41株(25.62%)blaOXA-1基因阳性,对青霉素- g、头孢曲松、头孢吡肟、阿莫西林、替加环素、亚胺培南和厄他培南的耐药模式与阴性菌株不同。blaOXA-1基因阳性肺炎克雷伯菌对青霉素- g的耐药率为100%,其次是头孢曲松(92.7%)、头孢吡肟和阿莫西林(80.5%)。对亚胺培南和厄他培南的耐药率分别为46.3%和41.5%,四环素无耐药。结论质粒相关blaOXA-1基因在肺炎克雷伯菌分离株中的存在,可能与这些细菌对β -内酰胺酶类抗生素的多重耐药机制以及其他内部耐药机制有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association of Blaoxa-1 Gene with Multidrug Resistance in K. pneumoniae Clinical Isolates
OBJECTIVES This study aimed to isolate K. pneumoniae from patients samples and find an association of the plasmid-mediated bla-OXA-1 gene with multidrug-resistant K. pneumoniae. METHODOLOGY This cross-sectional study was conducted at Mardan Medical Complex and Khyber Medical University Peshawar. K. pneumoniae was isolated from pus, urine and blood samples by culture and confirmed by biochemical techniques. Antibiotic susceptibility was done by disc diffusion according to the CLSI 2022 guidelines. A polymerase chain reaction was done for the gene after extraction and amplification of plasmid DNA. Furthermore, an association of antibiotic resistance was confirmed with blaOXA-1. RESULTSA total of 160 K. pneumoniae isolates were cultured from the patient’s samples, including pus (135, 84.37%), urine (15, 9.37%) and blood (10, 6.26%). There were 154 (96.3%) isolates resistant to Penicillin-G, followed by Ceftriaxone 151 (94.4%), Cefepime 143 (89.4%), Amoxicillin 125 (78.1%), Tigecycline 110 (68.8%), Imipenem 92 (57.6%) and Ertapenem 75(49.9%). However, Tetracycline had 1.9% resistance. The blaOXA-1 gene was positive in 41(25.62%) isolates with a different pattern of antibiotics resistance to Penicillin-G, Ceftriaxone, Cefepime, Amoxicillin, Tigecycline, Imipenem and Ertapenem as compared to the negative isolates. Among the blaOXA-1 gene-positive K. pneumoniae isolates, resistance to Penicillin-G was 100%, followed by Ceftriaxone (92.7%), Cefepime and Amoxicillin (80.5%), respectively. However, resistance to Imipenem and Ertapenem was 46.3% and 41.5%, respectively, and Tetracycline was not resistant. CONCLUSION Our data suggest that the presence of plasmid associated blaOXA-1 gene in K. pneumoniae isolates may contribute to multidrug resistance in beta lactamase-containing antibiotics along with other internal mechanisms of resistance present in these bacteria.
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