外排泵、外膜渗透性和β-内酰胺酶的产生对多重耐药、广泛耐药和泛耐药肺炎克雷伯菌耐药性特征的影响

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2024-09-16 DOI:10.1016/j.jiph.2024.102544

Rawaa A. Hussein , Shaymaa H. AL-Kubaisy , Mushtak T.S. Al-Ouqaili

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引用次数: 0

摘要

背景机会性肺炎克雷伯氏菌是引起院内感染的重要原因。本研究收集了所有患者的尿液、伤口、痰液和血液样本。本研究旨在检测肺炎克雷伯菌分离株的抗生素耐药性概况、MDR、XDR、PDR 的频率以及外排泵和外膜渗透性基因的检测情况。从患者中收集了 55 株肺炎克氏菌。使用 VITEK®2 Compact B 系统检测所研究细菌的抗生素耐药性模式。根据既定指南将分离菌株分为 MDR、XDR 或 PDR。数据采用临床和实验室标准协会（CLSI）的断点进行分析。在研究的 120 份样本中，45.83%（55 份）的肺炎克雷伯菌检测结果呈阳性。分离菌株对头孢唑啉、头孢曲松（98.2%）、氨苄西林（100%）、头孢他啶、头孢吡肟（90.9%）的耐药性最强。发现 20% 的分离菌株会产生金属内酰胺酶，41.81% 的分离菌株的广谱 beta 内酰胺酶检测呈阳性。总体而言，多重耐药（MDR）、广泛耐药（XDR）和泛耐药（PDR）分离株的比例分别为 57.2%、10.9% 和 9.09%。此外，外排泵基因 acrAB、mdtK 和 tolC 的流行率分别为 94.54 %、14.54 % 和 89.09 %，而在 96.36 % 和 98.18 % 的分离物中发现了孔蛋白编码基因 ompK35 和 ompK36。研究分离菌株对氨苄西林、头孢唑啉和头孢曲松的耐药性频率较高。大多数菌株被归类为 MDR 菌株，其中 6 株为 XDR 菌株，5 株为 PDR 菌株。耐多药肺炎克雷伯菌株产生抗生素耐药性的主要途径之一是通过 acrAB 外排系统。acrAB、tolC、ompk35 和 ompK36 基因的高流行率增加了这些分离株对抗抗菌治疗的能力。

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The influence of efflux pump, outer membrane permeability and β-lactamase production on the resistance profile of multi, extensively and pandrug resistant Klebsiella pneumoniae

Background

An important chance of nosocomial acquired infections are caused by the opportunistic bacterium Klebsiella pneumoniae. Urine, wound, sputum, and blood samples were collected from all patients. This study aimed to detect the antibiotic resistance profile, the frequency of MDR, XDR, PDR, and detection of efflux pump and outer membrane permeability genes in K. pneumoniae isolates.

Methods

One hundred twenty samples were collected from patients who were admitted to the Ramadi Teaching Hospitals in Al-Anbar Governorate. Fifty five of K. pneumoniae strains were collected from patients. The VITEK®2 Compact B System was used to detect the antibiotic resistance pattern of studied bacteria. The isolates were classified as MDR, XDR, or PDR based on established guidelines. The data were analyzed using Clinical and Laboratory Standards Institute (CLSI) breakpoints. PCR was used to detect the efflux pumps and porins genes.

Results

Out of the 120 samples studied, 45.83 % (55) tested positive for K. pneumoniae. The isolates displayed the greatest amount of resistance to cefazolin, ceftriaxone (98.2 %), ampicillin (100 %), and ceftazidime, cefepime (90.9 %). 20 % of the isolates were found to produce metallo-lactamases, and 41.81 % tested positive for extended-spectrum beta-lactamases. Overall, the rates of multi-drug resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) isolates were 57.2 %, 10.9 %, and 9.09 %, respectively. Additionally, the prevalence of efflux pump genes acrAB, mdtK, and tolC were 94.54 %, 14.54 %, and 89.09 %, respectively, while the porin-encoding genes ompK35 and ompK36 were found in 96.36 % and 98.18 % of the isolates.

Conclusion

This investigation concluded that the study isolates had a high degree of antibiotic resistance heterogenicity. High frequencies of resistance to ampicillin, cefazolin, and ceftriaxone are present in study isolates. Most strains were categorized as MDR strains, with six being XDR strains and five being PDR strains. One of the main routes of antibiotic resistance in multidrug-resistant K. pneumoniae strains is through the acrAB efflux system. The high prevalence of the acrAB, tolC, ompk35, and ompK36 genes were increases the ability of these isolates combat antimicrobial treatments.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.