从一家三级护理医院的临床样本中分离出的革兰氏阴性菌中进行ESBL和AMPCβ内酰胺酶的表型检测

Dasari Bhavana, Shabnum Musaddiq, SAILEELA K
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摘要

目的:表达广谱β-内酰胺酶(ESBLs)和AmpC的耐药革兰氏阴性杆菌在医院内感染中构成了严重的治疗威胁。经济有效的筛查方法是患者的福音。本研究旨在检测革兰氏阴性杆菌及其抗生素敏感性模式,以及检测革兰氏阴性杆菌中产生 ESBL 和 AmpC 的分离菌株:方法:对 150 份样本进行了前瞻性研究。方法:对 150 份样本进行了前瞻性研究,分离了革兰氏阴性杆菌,并采用柯比鲍尔盘扩散法对其进行了抗生素敏感性测试。使用头孢唑肟盘片筛选潜在的 ESBL 生产者,使用头孢西丁盘片通过盘片扩散法筛选 AmpC 生产者。使用头孢他啶和头孢他啶/克拉维酸圆片,通过联合圆片扩散检测法确认 ESBL 生产者。AmpC生产者通过头孢西丁-氯唑西林双盘协同试验进行确认:在 150 份样本中,约 38% 为革兰氏阴性杆菌,其中 40.35% 为大肠埃希菌,其次是铜绿假单胞菌(35.08%)。大肠埃希菌对亚胺培南、美罗培南和复方新诺明的敏感性最高。铜绿假单胞菌对哌拉西林/他唑巴坦、亚胺培南、美罗培南和头孢他啶的敏感性最高。28.07%的革兰氏阴性分离物产ESBL,其中以大肠杆菌(11株)最多;15.78%的分离物产AmpC,其中以大肠杆菌(4株)最多。有 7 个分离菌既产 ESBL 又产 AmpC:结论:常规筛查和及时报告 ESBL 和 AmpC 生产者有助于防止耐多药菌株的传播。抗生素耐药性监测有助于实施严格的感染控制和预防措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
PHENOTYPIC DETECTION OF ESBL AND AMPC BETA LACTAMASES AMONG GRAM-NEGATIVE ISOLATES FROM CLINICAL SAMPLES IN A TERTIARY CARE HOSPITAL
Objectives: Drug-resistant Gram-negative bacilli expressing extended-spectrum beta-lactamases (ESBLs) and AmpC pose a serious therapeutic threat in nosocomial infections. Cost-effective screening methods are a boon to patients. This study aims to detect gram-negative bacilli and their antibiotic sensitivity patterns, as well as detect the ESBL and AmpC-producing isolates among Gram-negative bacilli. Methods: A prospective study was conducted with 150 samples. Gram-negative bacilli were isolated, and their antibiotic sensitivity tests were performed by the Kirby–Bauer disk diffusion method. Potential ESBL producers were screened using Ceftazidime disc, and AmpC producers were screened by Cefoxitin discs by the disc diffusion method. ESBL producers were confirmed by the combined disc diffusion assay method using ceftazidime and ceftazidime/Clavulanic acid disc. AmpC producers were confirmed by the Cefoxitin Cloxacillin Double Disc Synergy Test. Results: About 38% of 150 samples were gram-negative bacilli, of which 40.35% were Escherichia coli, followed by Pseudomonas aeruginosa (35.08%). Maximum sensitivity by E. coli was found toward imipenem, meropenem, and cotrimoxazole. P. aeruginosa showed maximum sensitivity toward piperacillin/tazobactam, imipenem, meropenem, and ceftazidime. 28.07% of Gram-negative isolates were ESBL producers, with E. coli (11 isolates) being the maximum, and 15.78% were AmpC producers, with E. coli (four isolates) being the maximum. Seven isolates were both ESBL and AmpC producers. Conclusion: Routine screening and timely reporting of ESBL and AmpC producers help in preventing the spread of multidrug-resistant strains. Antibiotic resistance surveillance helps in the implementation of strict infection control and prevention practices.
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