背景:医院感染(NIs)是世界范围内的主要挑战。本研究的目标是鉴定抗生素耐药模式超广谱β-内酰胺酶(ESBLs)和耐碳青霉烯类肠杆菌(CRE)。
方法:在这项横断面研究中,本研究确定了从ICUNIs患者中收集的细菌分离株的抗菌药物敏感性模式.总的来说,对来自不同感染部位的42株大肠埃希菌和肺炎克雷伯菌进行ESBLs表型检测,金属-β-内酰胺酶(MBL)和CRE。ESBLs的检测,通过聚合酶链反应(PCR)方法进行MBL和CRE基因。
结果:来自71例NIs患者,分离出103种不同的细菌菌株。最常见的细菌是大肠杆菌(n=29;28.16%),鲍曼不动杆菌(n=15;14.56%),和肺炎克雷伯菌(n=13;12.26%)。此外,多重耐药(MDR)分离株的发生率为58.25%(60/103)。基于表型确认测试,32株(76.19%)大肠杆菌和肺炎克雷伯菌产生ESBLs,6个(14.28%)分离株被鉴定为CRE生产者。PCR显示blaCTX-M在ESBL基因中的高患病率(n=29;90.62%)。此外,blaNDM在4(66.66%)中检测到,blaOXA-23在3(50%),和blaOXA-48基因在1个(16.66%)分离株中。BlaVIM,blaKPC,和blaIMP基因在任何分离物中都没有检测到。
结论:革兰氏阴性菌大肠杆菌,A.鲍曼尼,高耐药水平的肺炎克雷伯菌是ICU中引起NIs的最常见细菌。这项研究首次在伊朗伊兰市的大肠杆菌和肺炎克雷伯菌中鉴定了blaOXA-11,blaOXA-23和blaNDM-1基因。
BACKGROUND: Nosocomial infections (NIs) are a major challenge worldwide. Identification of antibiotic resistance pattern extended spectrum beta-lactamases (ESBLs) and carbapenem-resistant Enterobacteriaceae (CRE) were the objectives of this study.
METHODS: In this cross-sectional study, the antimicrobial susceptibility pattern of bacterial isolates collected from patients with NIs in ICU was determined. Overall, 42 Escherichia coli and Klebsiella pneumoniae isolates from different infection sites were used to determine phenotypic tests of ESBLs, Metallo-β-lactamases (MBLs) and CRE. Detection of ESBLs, MBLs and CRE genes were performed by the polymerase chain reaction (PCR) method.
RESULTS: From 71 patients with NIs, 103 different bacterial strains were isolated. The most frequently isolated bacteria were E. coli (n = 29; 28.16%), Acinetobacter baumannii (n = 15; 14.56%), and K. pneumoniae (n = 13; 12.26%). Also, the rate of multidrug-resistant (MDR) isolates was 58.25% (60/103). Based on phenotypic confirmation tests, 32 (76.19%) isolates of E. coli and K. pneumoniae produced ESBLs, and 6 (14.28%) isolates were identified as CRE producers. PCR showed the high prevalence of the blaCTX-M (n = 29; 90.62%) in ESBL genes. In addition, blaNDM was detected in 4 (66.66%), blaOXA-23 in 3 (50%), and blaOXA-48 gene in 1 (16.66%) isolates. The blaVIM, blaKPC, and blaIMP genes were not detected in any of the isolates.
CONCLUSIONS: The Gram-negative bacteria E. coli, A. baumannii, and K. pneumoniae with high resistance levels were the most common bacteria causing NIs in the ICU. This study for the first time identified blaOXA-11, blaOXA-23, and blaNDM-1 genes in E. coli and K. pneumoniae in Ilam city of Iran.