背景:产超广谱β-内酰胺酶(ESBL)和耐碳青霉烯的肠杆菌(CRE)的全球传播引起了人们的极大关注。获得抗菌素抗性基因导致对几种抗生素的抗性,限制治疗选择。我们旨在研究临床环境中ESBL的产生和CRE的传播。
方法:从临床样本中,获得227个产生ESBL和CRE的分离株。将分离物在细菌培养基上培养并通过VITEK2确认。使用VITEK2测试了针对几种抗生素的抗生物图。通过PCR鉴定获得的抗性基因。
结果:在227个临床分离株中,肺炎克雷伯菌145株(63.8%),大肠埃希菌82株(36.1%);尿液中检出76株(33.4%),57(25.1%)在脓液拭子中,和53(23.3%)的血液样本。共有58(70.7%)产ESBL的大肠杆菌对β-内酰胺类抗生素耐药,除了碳青霉烯类,17.2%的大肠杆菌对阿米卡星耐药;29.2%的大肠杆菌对碳青霉烯类耐药。共有106例(73.1%)产ESBL的肺炎克雷伯菌对所有β-内酰胺类耐药,除了碳青霉烯类,环丙沙星占66.9%;38例(26.2%)肺炎克雷伯菌对碳青霉烯类抗生素耐药。粘菌素是针对两种细菌类型的最有效的抗生素。12株(20.6%)大肠杆菌blaCTX-M阳性,11(18.9%)为blaTEM,blaNDM为8(33.3%)。46(52.3%)肺炎克雷伯菌分离株有blaCTX-M,27(18.6%)blaTEM,和26(68.4%)blaNDM。
结论:这项研究发现产生耐药性ESBL和CRE的患病率很高,强调需要有针对性地使用抗生素来对抗耐药性。
BACKGROUND: The global spread of extended-spectrum beta-lactamase (
ESBL)-producing and carbapenem-resistant Enterobacterales (CRE) poses a significant concern. Acquisition of antimicrobial resistance genes leads to resistance against several antibiotics, limiting treatment options. We aimed to study
ESBL-producing and CRE transmission in clinical settings.
METHODS: From clinical samples, 227
ESBL-producing and CRE isolates were obtained. The isolates were cultured on bacterial media and confirmed by VITEK 2. Antibiograms were tested against several antibiotics using VITEK 2. The acquired resistance genes were identified by PCR.
RESULTS: Of the 227 clinical isolates, 145 (63.8%) were Klebsiella pneumoniae and 82 (36.1%) were Escherichia coli; 76 (33.4%) isolates were detected in urine, 57 (25.1%) in pus swabs, and 53 (23.3%) in blood samples. A total of 58 (70.7%)
ESBL-producing E. coli were resistant to beta-lactams, except for carbapenems, and 17.2% were amikacin-resistant; 29.2% of E. coli isolates were resistant to carbapenems. A total of 106 (73.1%) ESBL-producing K. pneumoniae were resistant to all beta-lactams, except for carbapenems, and 66.9% to ciprofloxacin; 38 (26.2%) K. pneumoniae were resistant to carbapenems. Colistin emerged as the most effective antibiotic against both bacterial types. Twelve (20.6%) E. coli isolates were positive for blaCTX-M, 11 (18.9%) for blaTEM, and 8 (33.3%) for blaNDM. Forty-six (52.3%) K. pneumoniae isolates had blaCTX-M, 27 (18.6%) blaTEM, and 26 (68.4%) blaNDM.
CONCLUSIONS: This study found a high prevalence of drug-resistant
ESBL-producing and CRE, highlighting the need for targeted antibiotic use to combat resistance.