PDF(Pubmed)
Abstract：
The resistance to antibiotics in Gram-negative bacilli causing sepsis is a warning sign of failure of therapy. Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. coli) represent major Gram-negative bacilli associated with sepsis. Quinolone resistance is an emerging resistance among E. coli and K. pneumoniae. Therefore, the present study aimed to study the presence of plasmid-mediated quinolone resistance (PMQR) genes qnrA, qnrB, and qnrS by polymerase chain reaction (PCR) in E. coli and K. pneumoniae isolated from pediatric patients with sepsis. This was a retrospective cross-sectional study that included pediatric patients with healthcare-associated sepsis. The E. coli and K. pneumoniae isolates were identified by microbiological methods. PMQR genes namely qnrA, qnrB, and qnrS were detected in E. coli and K. pneumoniae isolates by PCR. The results were analyzed by SPPS24, and the qualitative data was analyzed as numbers and percentages and comparison was performed by Chi-square test, P was significant if < 0.05. The most prevalent gene detected by PCR was qnrA (75%), followed by qnrB (28.1%), and qnrS (25%). The most frequently detected qnr gene in E coli and K. pneumoniae was qnrA (28.8%, and 16.3% respectively). The present study highlights the high prevalence of ciprofloxacin resistance among E. coli and K. pneumoniae isolated from pediatric patients with healthcare-associated sepsis. There was a high frequency of PMQR genes in E. coli and K. pneumoniae isolated from pediatric patients. Therefore, it is important to monitor the spread of PMQR genes in clinical isolates to ensure efficient antibiotic use in those children. The finding denotes the importance of an antibiotics surveillance program.
摘要：
引起脓毒症的革兰氏阴性杆菌对抗生素的耐药性是治疗失败的警告信号。肺炎克雷伯菌(K.肺炎）和大肠杆菌（E.大肠杆菌）代表与脓毒症相关的主要革兰氏阴性杆菌。喹诺酮耐药是大肠杆菌和肺炎克雷伯菌中新兴的耐药。因此,本研究旨在研究质粒介导的喹诺酮类耐药(PMQR)基因qnrA,qnrB,和qnrS通过聚合酶链反应（PCR）从儿科脓毒症患者中分离出的大肠杆菌和肺炎克雷伯菌。这是一项回顾性的横断面研究，包括患有医疗保健相关败血症的儿科患者。通过微生物学方法鉴定大肠杆菌和肺炎克雷伯菌分离株。PMQR基因即qnrA，qnrB,通过PCR检测大肠杆菌和肺炎克雷伯菌中的qnrS。结果采用SPPS24进行分析,定性数据采用数字和百分比进行分析,比较采用卡方检验,如果<0.05,则P显著。PCR检测到的最普遍的基因是qnrA（75％），其次是qnrB(28.1%)，和qnrS（25%）。在大肠杆菌和肺炎克雷伯菌中最常见的qnr基因是qnrA(28.8%,和16.3%）。本研究强调了环丙沙星耐药的高流行的大肠杆菌和肺炎克雷伯菌从儿科患者与医疗保健相关的败血症。在从儿科患者分离的大肠杆菌和肺炎克雷伯菌中存在高频率的PMQR基因。因此,重要的是监测PMQR基因在临床分离株中的传播,以确保这些儿童有效使用抗生素.这一发现表明了抗生素监测计划的重要性。
