北方邦西部农村医院临床分离的肺炎克雷伯菌生物膜形成和碳青霉烯类耐药性评估

IF 1.1 Q4 PRIMARY HEALTH CARE
Shashikant Jaisal, Amit Singh, Rajesh K Verma, Vidya Sagar Ram, Shesh Kumar Verma, Himanshi Yadav, Vijay Prakash
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引用次数: 0

摘要

肺炎克雷伯菌通常引起卫生保健相关感染,并表现出多药耐药性。肺炎克雷伯菌可以产生生物膜。肺炎克雷伯菌的碳青霉烯类耐药主要是由于碳青霉烯酶的产生。本研究旨在评价肺炎克雷伯菌分离株生物膜的形成和碳青霉烯酶耐药性。材料与方法:从各种临床标本中分离肺炎克雷伯菌110株,采用Kirby纸片扩散法进行药敏试验,采用组织培养平板法进行生物膜检测。所有碳青霉烯耐药菌株均经多重实时荧光定量PCR (mPCR)鉴定。采用改良霍奇试验(MHT)、改良碳青霉烯类失活法(mCIM)和乙二胺四乙酸(EDTA)改良碳青霉烯类失活法(eCIM)检测碳青霉烯类酶基因阳性。结果:110株克雷伯菌经Kirby-Bauer纸片扩散法鉴定为碳青霉烯类耐药菌株,66%(72/110)为碳青霉烯类产生菌,58%(42/72)为碳青霉烯类产生菌。碳青霉烯酶基因数量最多的是新德里金属β-内酰胺酶(NDM),共产酶(NDM+OXA-48)占52% (N = 22),共产酶(NDM+OXA-48)占29% (N = 12),共产酶(OXA-48)占19% (N = 8)。MHT和mCIM+eCIM的总敏感性分别为62%和93%,特异性分别为88%和97%。研究表明,51株肺炎克雷伯菌为中等生物膜产生菌(N = 56), 27株为强生物膜产生菌(N = 30), 22株为弱/无生物膜产生菌(N = 30)。生物膜的形成与耐碳青霉烯肺炎克雷伯菌(CR-KP)基因的相关性具有统计学意义,P值为0.01。*结论:大多数肺炎克雷伯菌具有广泛的抗生素耐药性,是生物膜的生产者。结果表明,与MHT相比,mCIM与eCIM联合检测CR-KP具有较高的敏感性和特异性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of biofilm formation and carbapenem resistance in Klebsiella pneumoniae isolated from clinical samples at a rural hospital in western Uttar Pradesh.

Introduction: Klebsiella pneumoniae commonly causes healthcare-associated infections and shows multidrug resistance. K. pneumoniae can produce biofilm. Carbapenem resistance in K. pneumoniae is due to the production of carbapenemases mainly. This study was done to evaluate the formation of biofilm and carbapenemase resistance in K. pneumoniae isolates.

Material and methods: A total of 110 K. pneumoniae isolated from various clinical samples were taken, the antibiotic susceptibility test was done by the Kirby disk diffusion method, and biofilm detection was done by the tissue culture plate method. All the carbapenem-resistant isolates were confirmed by multiplex real-time PCR (mPCR). Those found positive for any of the carbapenemase genes were tested by the modified Hodge test (MHT), modified carbapenem inactivation method (mCIM), and ethylenediamine tetraacetic acid (EDTA)-modified carbapenem inactivation method (eCIM).

Results: Out of 110 isolates, 66% (72/110) were carbapenem-resistant (suggestive of carbapenemase producers) by Kirby-Bauer disk diffusion but 58% (42/72) of Klebsiella isolates were confirmed for carbapenemase production by mPCR. Maximum number of carbapenemase gene were New Delhi metallo-β-lactamase (NDM) 52% (N = 22), 29% (N = 12) coproducers (NDM+OXA-48), and lowest in oxacillinase (OXA-48), 19% (N = 8). The overall sensitivity of MHT and mCIM+eCIM was 62% and 93%, and specificity was 88% and 97%, respectively. Our study showed that moderate biofilm producers were 51% (N = 56) K. pneumoniae isolates, strong biofilm producers 27% (N = 30), and 22% (N = 30) were weak/non-biofilm producers. We also found the correlation between biofilm formation and carbapenem-resistant K. pneumoniae (CR-KP) genes was statistically significant with a P value of 0.01*<0.05.

Conclusion: Most isolates of K. pneumoniae demonstrated a wide range of antibiotic resistance and were biofilm producers. Our results indicated that the combination of mCIM with eCIM showed high sensitivity and specificity to detect CR-KP compared with MHT.

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