耐碳青霉烯铜绿假单胞菌临床分离株的药敏分析

Rebecca Chinenye Ogba, Peace Oluchi Akpu, A. C. Nwuzo, I. Peter, Onyinye Lovette Nomeh, I. Iroha
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引用次数: 2

摘要

背景与目的:碳青霉烯耐药铜绿假单胞菌是对人类健康构成最大威胁的抗生素耐药重点病原体之一。近年来,铜绿假单胞菌对碳青霉烯类药物的耐药率在世界范围内呈上升趋势,严重限制了患者的治疗选择,引起了人们的高度关注。因此,本研究旨在确定耐碳青霉烯铜绿假单胞菌临床分离株的药敏特征。方法:从埃邦伊州阿巴卡利基Alex Ekwueme联邦大学教学医院(AFEUTHA)就诊的患者共收集500份临床样本。使用标准微生物学技术分离和鉴定细菌,分析收集的样品是否存在铜绿假单胞菌。使用VITEK 2系统进行进一步的应变确认。采用改良霍奇法对耐碳青霉烯铜绿假单胞菌进行表型检测。采用Kirby-Bauer盘片扩散法测定抗生素敏感性,采用临床实验室标准协会(CLSI)区径断点对结果进行解释。结果:铜绿假单胞菌在临床标本中的检出率为119例(23.8%),其中尿样检出率最高,为81例(27.4%),其次为伤口拭子检出率13例(25.5%),阴道拭子检出率高17例(20.7),导管针尖检出率最低,为5例(12.8%),痰液检出率最低,为3例(9.4%)。改良Hodge法检出耐碳青霉烯假单胞菌31株(6.2%),其中高比例24株(8.1%),其次是创面拭子5株(9.8%),而高剂量阴道拭子0株(0.0%)中无耐碳青霉烯假单胞菌。耐碳青霉烯铜绿假单胞菌对阿莫西林-克拉维酸100%、粘菌素100%、四环素100%、呋喃妥英70.8%、氨曲南87.5%耐药,对萘啶酸50.0%、氧氟沙星75.0%、环丙沙星100%敏感。结论:耐碳青霉烯类铜绿假单胞菌对氧氟沙星和环丙沙星的体外敏感性已知,合理使用氧氟沙星和环丙沙星可促进患者病情的显著改善。因此,迫切需要对不同类别的广谱和新疗法进行评估,以抵消碳青霉烯耐药铜绿假单胞菌迫在眉睫的耐药性危机。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Antibiotic Susceptibility Profile of Clinical Isolate of Carbapenem-Resistant Pseudomonas aeruginosa
Background and Objectives: Carbapenem-resistant Pseudomonas aeruginosa, are among the top tier of the list of antibiotic-resistant priority pathogens that pose the greatest threat to human health. In recent years, the rate of carbapenem resistance in Pseudomonas aeruginosa has increased worldwide and has become of great concern since it significantly restricts the therapeutic options for patients. Therefore this study was undertaken to determine the antibiotic susceptibility profile of the clinical isolate of Carbapenem-resistant Pseudomonas aeruginosa. Methodology: A total of five hundred (500) clinical samples were collected from patient’s attending Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State (AFEUTHA). The collected samples were analyzed for the presence of Pseudomonas aeruginosa using standard microbiological techniques for isolation and characterization of bacteria. Further strain confirmation was performed using VITEK 2 System. Phenotypic detection of Carbapenem-resistant Pseudomonas aeruginosa was performed using Modified Hodge testing. Antibiotic susceptibility was performed by employing Kirby-Bauer disk diffusion method and the results were interpreted using the Clinical Laboratory Standard Institute (CLSI) zone diameter breakpoints. Results: The occurrence rate of Pseudomonas aeruginosa in clinical samples accounted for 119(23.8%) consisting of a high proportion from urine sample 81(27.4%) followed by wound swabs 13(25.5%), high vaginal swabs 17(20.7) while the least occurrence rate was observed against catheter tips 5(12.8%) and sputum 3(9.4%). Modified Hodge testing revealed 31(6.2%) carbapenem-resistant Pseudomonas aeruginosa comprising of high proportion of 24(8.1%) from urine samples followed by wound swab 5(9.8%) while Carbapenem-resistant Pseudomonas aeruginosa was absent in High Vaginal Swab recording 0(0.0%). Carbapenem-resistant Pseudomonas aeruginosa isolates were highly resistant to amoxicillin-clavulanic 100%, colistin 100%, tetracycline 100%, nitrofurantoin 70.8%, aztreonam 87.5% but were susceptible to nalixidic acid 50.0 %, ofloxacin 75.0%, and ciprofloxacin 100%. Conclusion: As in-vitro susceptibility of carbapenem-resistant Pseudomonas aeruginosa isolates to ofloxacin and ciprofloxacin is known, their judicious utilization will accelerate a significant improvement in the patient's condition. As such, there is a substantial need for the evaluation of a wide spectrum and new therapies in different classes to counteract this imminent crisis of resistance among Carbapenem-resistant Pseudomonas aeruginosa.
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