PDF(Pubmed)
Abstract：
UNASSIGNED: In resource-constrained settings, limited antibiotic options make treating carbapenem-resistant bacterial infections difficult for healthcare providers. This study aimed to assess carbapenemase expression in Gram-negative bacteria isolated from clinical samples in Jimma, Ethiopia.
UNASSIGNED: A cross-sectional study was conducted to assess carbapenemase expression in Gram-negative bacteria isolated from patients attending Jimma Medical Center. Totally, 846 Gram-negative bacteria were isolated and identified using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Phenotypic antibiotic resistance patterns were determined using the Kirby-Bauer disk diffusion method and Etest strips. Extended-spectrum β-lactamase phenotype was determined using MAST disks, and carbapenemases were characterized using multiplex polymerase chain reactions (PCR).
UNASSIGNED: Among the isolates, 19% (157/846) showed phenotypic resistance to carbapenem antibiotics. PCR analysis revealed that at least one carbapenemase gene was detected in 69% (107/155) of these strains. The most frequently detected acquired genes were blaNDM in 35% (37/107), blaVIM in 24% (26/107), and blaKPC42 in 13% (14/107) of the isolates. Coexistence of two or more acquired genes was observed in 31% (33/107) of the isolates. The most common coexisting acquired genes were blaNDM + blaOXA-23, detected in 24% (8/33) of these isolates. No carbapenemase-encoding genes could be detected in 31% (48/155) of carbapenem-resistant isolates, with P. aeruginosa accounting for 85% (41/48) thereof.
UNASSIGNED: This study revealed high and incremental rates of carbapenem-resistant bacteria in clinical samples with various carbapenemase-encoding genes. This imposes a severe challenge to effective patient care in the context of already limited treatment options against Gram-negative bacterial infections in resource-constrained settings.
UNASSIGNED: A cross-sectional study was conducted to assess carbapenemase expression in Gram-negative bacteria isolated from patients attending Jimma Medical Center. Totally, 846 Gram-negative bacteria were isolated and identified using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Phenotypic antibiotic resistance patterns were determined using the Kirby-Bauer disk diffusion method and Etest strips. Extended-spectrum β-lactamase phenotype was determined using MAST disks, and carbapenemases were characterized using multiplex polymerase chain reactions (PCR).
UNASSIGNED: Among the isolates, 19% (157/846) showed phenotypic resistance to carbapenem antibiotics. PCR analysis revealed that at least one carbapenemase gene was detected in 69% (107/155) of these strains. The most frequently detected acquired genes were blaNDM in 35% (37/107), blaVIM in 24% (26/107), and blaKPC42 in 13% (14/107) of the isolates. Coexistence of two or more acquired genes was observed in 31% (33/107) of the isolates. The most common coexisting acquired genes were blaNDM + blaOXA-23, detected in 24% (8/33) of these isolates. No carbapenemase-encoding genes could be detected in 31% (48/155) of carbapenem-resistant isolates, with P. aeruginosa accounting for 85% (41/48) thereof.
UNASSIGNED: This study revealed high and incremental rates of carbapenem-resistant bacteria in clinical samples with various carbapenemase-encoding genes. This imposes a severe challenge to effective patient care in the context of already limited treatment options against Gram-negative bacterial infections in resource-constrained settings.
摘要：
■在资源受限的设置中，有限的抗生素选择使医疗保健提供者难以治疗耐碳青霉烯的细菌感染。本研究旨在评估从Jimma临床样本中分离的革兰氏阴性菌中碳青霉烯酶的表达，埃塞俄比亚。
■进行了一项横断面研究，以评估从Jimma医学中心就诊的患者中分离出的革兰氏阴性菌中的碳青霉烯酶表达。完全正确,使用基质辅助激光解吸电离-飞行时间质谱(MALDI-TOFMS)分离和鉴定846革兰氏阴性菌。使用Kirby-Bauer圆盘扩散方法和Etest条确定表型抗生素抗性模式。使用MAST圆盘确定超广谱β-内酰胺酶表型，和碳青霉烯酶使用多重聚合酶链反应（PCR）进行表征。
■在分离株中，19%(157/846)对碳青霉烯类抗生素表现出表型耐药。PCR分析显示在69%(107/155)的这些菌株中检测到至少一种碳青霉烯酶基因。最常见的获得性基因是35％的blaNDM（37/107），BlaVIM占24%（26/107），和blaKPC42在13%(14/107)的分离株中。在31%(33/107)的分离物中观察到两个或更多个获得的基因共存。最常见的共存获得性基因是blaNDM+blaOXA-23,在24%(8/33)的这些分离株中检测到。在31%(48/155)耐碳青霉烯分离株中未检测到碳青霉烯酶编码基因,铜绿假单胞菌占其85%(41/48)。
■这项研究揭示了具有各种碳青霉烯酶编码基因的临床样品中碳青霉烯类耐药细菌的高且递增率。在资源受限的环境中针对革兰氏阴性细菌感染的治疗选择已经有限的背景下，这对有效的患者护理提出了严峻的挑战。
■进行了一项横断面研究，以评估从Jimma医学中心就诊的患者中分离出的革兰氏阴性菌中的碳青霉烯酶表达。完全正确,使用基质辅助激光解吸电离-飞行时间质谱(MALDI-TOFMS)分离和鉴定846革兰氏阴性菌。使用Kirby-Bauer圆盘扩散方法和Etest条确定表型抗生素抗性模式。使用MAST圆盘确定超广谱β-内酰胺酶表型，和碳青霉烯酶使用多重聚合酶链反应（PCR）进行表征。
■在分离株中，19%(157/846)对碳青霉烯类抗生素表现出表型耐药。PCR分析显示在69%(107/155)的这些菌株中检测到至少一种碳青霉烯酶基因。最常见的获得性基因是35％的blaNDM（37/107），BlaVIM占24%（26/107），和blaKPC42在13%(14/107)的分离株中。在31%(33/107)的分离物中观察到两个或更多个获得的基因共存。最常见的共存获得性基因是blaNDM+blaOXA-23,在24%(8/33)的这些分离株中检测到。在31%(48/155)耐碳青霉烯分离株中未检测到碳青霉烯酶编码基因,铜绿假单胞菌占其85%(41/48)。
■这项研究揭示了具有各种碳青霉烯酶编码基因的临床样品中碳青霉烯类耐药细菌的高且递增率。在资源受限的环境中针对革兰氏阴性细菌感染的治疗选择已经有限的背景下，这对有效的患者护理提出了严峻的挑战。
