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在德黑兰的患者中分离的多重耐药铜绿假单胞菌中 ESBLs 基因的流行率。

Prevalence of ESBLs genes among multidrug-resistant isolates of Pseudomonas aeruginosa isolated from patients in Tehran.

机构信息

Department of Microbiology, Pasteur Institute of Iran, Tehran, Iran.

出版信息

Microb Drug Resist. 2009 Mar;15(1):37-9. doi: 10.1089/mdr.2009.0880.

DOI:10.1089/mdr.2009.0880
PMID:19265477
Abstract

Drug susceptibility testing and PCR assay were used to determine the antibiotic susceptibility patterns and prevalence of genes encoding five different extended spectrum betalactamases (ESBLs) (PER, VEB, SHV, GES, and TEM) among 600 isolates of Pseudomonas aeruginosa cultured from patients at two hospitals in Tehran. Susceptibility of isolates to 12 different antibiotics was tested using disk diffusion method. The MICs for ceftazidime and imipenem were also determined using microbroth dilution assay. Isolates showing MICs >or=16 for ceftazidime were subjected to PCR targeting bla(SHV), bla(PER), bla(GES), bla(VEB), and bla(TEM) genes that encode ESBL. The rates of resistance were as follows: tetracycline (92%), carbenicillin (62%), cefotaxime (56%), ceftriaxon (53%), piperacilin (46%), gentamicin (31%), piperacilin/tazobactam (28%), ceftazidime (25%), amikacin (23%), ciprofloxacin (19.5%), and imipenem (6%). Thirty-nine percent of isolates (n = 234) showed MICs >or=16 microg/ml for ceftazidime, and 5.45% showed MICs >or=16 microg/ml for imepenem. The imipenem-resistant isolates showed high rate of susceptibility to colistin (89%) and polymixin B (95.5%). The frequency of bla(VEB), bla(SHV), bla(PER), bla(GES), and bla(TEM) among the ESBL isolates (MIC >or=16) were 24%, 22%, 17%, 0%, and 9%, respectively. Isolates containing bla(VEB) were resistant to almost all tested antibiotics except imepenem. This is the first report on the existence of bla(VEB), and bla(PER) in Iran. Colistin and polymixin B are highly potent against the imipenem-resistant isolates of P. aeruginosa.

摘要

药物敏感性测试和 PCR 检测用于确定来自德黑兰两家医院患者的 600 株铜绿假单胞菌分离株的抗生素敏感性模式和编码五种不同扩展谱β内酰胺酶(ESBL)(PER、VEB、SHV、GES 和 TEM)的基因的流行率。使用纸片扩散法测试分离物对 12 种不同抗生素的敏感性。使用微量肉汤稀释法还确定了头孢他啶和亚胺培南的 MIC。对于头孢他啶 MICs>or=16 的分离株,进行针对 bla(SHV)、bla(PER)、bla(GES)、bla(VEB)和 bla(TEM)基因的 PCR。编码 ESBL 的基因。耐药率如下:四环素(92%)、卡宾西林(62%)、头孢噻肟(56%)、头孢曲松(53%)、哌拉西林(46%)、庆大霉素(31%)、哌拉西林/他唑巴坦(28%)、头孢他啶(25%)、阿米卡星(23%)、环丙沙星(19.5%)和亚胺培南(6%)。39%的分离株(n=234)头孢他啶 MICs>or=16 μg/ml,5.45%的分离株亚胺培南 MICs>or=16 μg/ml。耐亚胺培南的分离株对粘菌素(89%)和多粘菌素 B(95.5%)的敏感性较高。ESBL 分离株(MIC>or=16)中 bla(VEB)、bla(SHV)、bla(PER)、bla(GES)和 bla(TEM)的频率分别为 24%、22%、17%、0%和 9%。携带 bla(VEB)的分离株几乎对所有测试的抗生素均耐药,除亚胺培南外。这是伊朗首次报道 bla(VEB)和 bla(PER)的存在。粘菌素和多粘菌素 B 对耐亚胺培南的铜绿假单胞菌分离株具有很强的作用。

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