尼泊尔一家三级儿童医院中产ESBL的大肠杆菌和克雷伯氏菌尿液分离物的表型特征。

IF 3.6 Q1 TROPICAL MEDICINE
Santosh Pantha, Hiramani Parajuli, Charu Arjyal, Shovana Thapa Karki, Dhiraj Shrestha
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引用次数: 0

摘要

背景:泌尿道病原体,尤其是大肠杆菌和克雷伯氏菌属,产生广谱β-内酰胺酶(ESBLs)是一个严重的公共卫生问题。本研究探讨了从尼泊尔一家三级儿童医院获得的尿液样本中分离出的产ESBL大肠杆菌和克雷伯氏菌的流行病学:2016年8月至2017年2月进行了一项横断面研究。共从 13 岁以下的儿科患者处采集了 745 份清洁的尿液样本,并进行了半定量培养。采用标准实验室方案对大肠杆菌和克雷伯氏菌进行了鉴定。抗生素敏感性测试采用柯比-鲍尔盘扩散法进行,ESBL生产者的表型鉴定采用组合盘法进行:结果:在细菌分离物中,以大肠杆菌为主,阳性病例有 139 例(81.8%)。值得注意的是,大肠杆菌对硝基呋喃妥因的敏感性很高,有 117 个(84.2%)分离菌株对硝基呋喃妥因敏感。同时,肺炎克氏菌对庆大霉素的敏感性较高,有 21 个(91.3%)分离菌株对庆大霉素敏感。在 163 个大肠杆菌和克雷伯氏菌分离株中,有 62 个(38.0%)被鉴定为多重耐药菌(MDR),其中 42 个(25.8%)被确认为表型 ESBL 生产者。值得注意的是,所有41个(100%)产生ESBL的大肠杆菌分离株都对亚胺培南敏感:结论:儿科患者分离出的大肠杆菌和肺炎双球菌中普遍存在 ESBL 生产者,这凸显了抗菌药物管理的重要性。硝基呋喃妥因和庆大霉素是治疗儿童这些病原体的有效经验选择。然而,耐多药和产生 ESBL 的高发率凸显了常规监测和早期检测策略对有效控制此类感染的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Phenotypic characterization of ESBL-producing urinary isolates of E. coli and Klebsiella spp. in a tertiary care children's hospital in Nepal.

Background: The production of extended-spectrum beta-lactamases (ESBLs) among uropathogens, particularly E. coli and Klebsiella spp., poses a severe public health concern. This study explored the epidemiology of ESBL-producing E. coli and Klebsiella spp. isolated from urine samples obtained at a tertiary care children's hospital in Nepal.

Methods: A cross-sectional study was conducted from August 2016 to February 2017. A total of 745 clean catch urine samples were obtained from pediatric patients under the age of 13 and subjected to semiquantitative culture. E. coli and Klebsiella spp. were identified using standard laboratory protocols. Antibiotic susceptibility testing was performed using the Kirby-Bauer disc diffusion method, and ESBL producers were phenotypically identified using the combined disk method.

Results: Among the bacterial isolates, E. coli predominated, accounting for 139 (81.8%) positive cases. Notably, E. coli showed high susceptibility to nitrofurantoin, with 117 (84.2%) isolates being susceptible. Meanwhile, K. pneumoniae showed high susceptibility to gentamicin, with 21 (91.3%) isolates being susceptible. Of the 163 isolates of E. coli and Klebsiella spp., 62 (38.0%) were identified as multidrug-resistant (MDR), with 42 (25.8%) confirmed as phenotypic ESBL producers. Remarkably, all 41 (100%) ESBL-producing E. coli isolates were susceptible to imipenem.

Conclusions: The prevalence of ESBL producers among E. coli and K. pneumoniae isolates from pediatric patients underscores the importance of antimicrobial stewardship. Nitrofurantoin and gentamicin emerge as effective empirical treatment choices against these pathogens in children. However, the high rates of multidrug resistance and ESBL production highlight the necessity for routine surveillance, and early detection strategies to manage such infections effectively.

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来源期刊
Tropical Medicine and Health
Tropical Medicine and Health TROPICAL MEDICINE-
CiteScore
7.00
自引率
2.20%
发文量
90
审稿时长
11 weeks
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