尼日利亚阿布贾卡尔希综合医院患者大肠埃希菌的抗菌药耐药性概况和广谱β-内酰胺酶耐药基因

Bassey A.P, Ngwai Y.B, Nkene I.H, Tama S.C, Igbawua I.N, Bassey B.E
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引用次数: 0

摘要

目的:本研究调查了尼日利亚阿布贾卡尔希综合医院患者尿液中大肠埃希菌的抗菌药耐药性概况和广谱β-内酰胺酶耐药基因:横断面研究:研究地点和时间:2022 年 8 月至 2023 年 2 月,位于凯菲的纳萨拉瓦州立大学微生物学系:从患者身上共采集了 120 份样本。采用标准微生物学方法从样本中分离出大肠埃希氏菌。按照临床和实验室标准研究所(CLSI)的规定对抗生素敏感性测试进行评估。采用双盘协同试验检测大肠杆菌分离物中 ESBL 的产生。 此外,还采用聚合酶链反应(PCR)方法对 ESBL 基因进行了分子检测:结果:大肠埃希氏菌感染率为 17.5%(21/120),其中 2 例阳性(9.5%)为男性,19 例(90.5%)为女性。抗生素耐药性依次为:磺胺甲恶唑/三甲氧苄啶(SXT:81.0%)、阿莫西林/克拉维酸(AMC:61.9%)、氧氟沙星(OFX:66.7%)、头孢他啶(CTX:53.4%)、庆大霉素(CN:42.9%)、头孢曲松(CRO:33.3%)、亚胺培南(IPM:33.3%)、美罗培南(MOR:42.4%)、硝基呋喃妥因(NET:20.3%)和环丙沙星(CIP:23.8%)。最常见的抗生素耐药表型是 CIP-OFX-SXT(23.8%)。在 90.5%(19/21)的分离物中观察到多重抗生素耐药性(MAR),常见的 MAR 指数为 0.3(23.8%)。在 21 个对β-内酰胺耐药的分离物中,有 6 个(28.5%)被证实为 ESBL 生产者。6 个 ESBL 阳性分离物携带的 bla 基因如下:blaTEM(1/6,16.7%)和 blaCTX-M(1/6,16.7%):尼日利亚阿布贾卡尔希综合医院患者尿液中分离出的大肠杆菌对环丙沙星、硝基呋喃妥因、美罗培南和亚胺培南的耐药性较低。这意味着这些抗生素可用于治疗大肠杆菌引起的感染。此外,ESBL 阳性的大肠杆菌分离物含有 ESBL 基因,其中 blaCTX-M 和 blaTEM 最为常见。
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 Profile and Extended Spectrum Beta-lactamase Resistance Genes in Escherichia coli from Patients in General Hospital, Karshi, Abuja, Nigeria
Aims: This study investigated the antimicrobial resistance profile and extended spectrum beta-lactamase resistance genes in Escherichia coli of from urine of patients sourced from General Hospital, Karshi, Abuja, Nigeria. Study Design: Cross-sectional study. Place and Duration of Study: Department of Microbiology, Nasarawa State University, Keffi, between August 2022 and February 2023. Methodology: A total of 120 samples were collected from patients. Escherichia coli was isolated from the samples using standard microbiological methods. Antibiotic susceptibility testing was evaluated as described by the Clinical and Laboratory Standards Institute (CLSI). The detection of ESBL production in E. coli isolates was carried out using double disc synergy test.  In addition, molecular detection of ESBL genes was carried out using Polymerase Chain Reaction (PCR) method. Results: The prevalence of E. coli was 17.5% (21/120), out of which two (2) of the positive isolates (9.5%) were male, and 19 (90.5%) female. Antibiotic resistances in the isolates in decreasing order were as follows: sulphamethoxazole / trimethoprim (SXT: 81.0%), amoxicillin/clavulanic acid (AMC: 61.9%), ofloxacin (OFX: 66.7%), cefotaxime (CTX: 53.4%), gentamicin (CN: 42.9%), ceftriaxone (CRO: 33.3%), imipenem (IPM: 33.3%), meropenem (MOR: 42.4%), nitrofurantoin (NET: 20.3%) and ciprofloxacin (CIP: 23.8%). The commonest antibiotic resistant resistance phenotype was CIP-OFX-SXT (23.8%). Multiple antibiotic resistance (MAR) was observed in 90.5% (19/21) of the isolates, with the common MAR index being 0.3 (23.8%). Six of the twenty one beta-lactam resistant isolates (28.5%) were confirmed ESBL producers. The 6 ESBL positive isolates carried bla genes as follows: blaTEM (1/6, 16.7%) and blaCTX-M (1/6, 16.7%). blaSHV only was not found in any of the isolates. Conclusion: The E. coli isolates from urine of patients in General Hospital, Karshi, Abuja, Nigeria was less resistant to ciprofloxacin, nitrofurantoin, meropenem and imipenem. This implies that the antibiotics are useful in the treatment of infection caused by E. coli. Also, ESBL-positive E. coli isolates harbored ESBL genes, with blaCTX-M and blaTEM as the most common.
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