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1类整合子与铜绿假单胞菌临床分离株对亚胺培南的耐药性:流行情况及药敏分析

Class 1 integron and Imipenem Resistance in Clinical Isolates of Pseudomonas aeruginosa: Prevalence and Antibiotic Susceptibility.

作者信息

Yousefi S, Nahaei Mr, Farajnia S, Ghojazadeh M, Akhi Mt, Sharifi Y, Milani M, Ghotaslou R

机构信息

Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Iran J Microbiol. 2010 Sep;2(3):115-21.

Abstract

BACKGROUND AND OBJECTIVES

Pseudomonas aeruginosa is one of the most important causative agents of nosocomial infections especially in ICU and burn units. P. aeruginosa infections are normally difficult to eradicate due to acquired resistance to many antibiotics. Recent appearance of carbapenem resistant P. aeruginosa isolates is considered a major healthcare problem. The present study was conducted to detect class 1 integron and antibiotic susceptibility profiles of imipenem-sensitive and resistant clinical isolates of P. aeruginosa.

MATERIALS AND METHODS

Antibiotic susceptibility profiles and minimum inhibitory concentration against imipenem was studied in 160 clinical isolates of P. aeruginosa by disk agar diffusion method and Etest, respectively. Detection of class 1 integron was performed by the PCR method. Demographic and microbiological data were compared between imipenem susceptible and non-susceptible isolates by the SPSS software.

RESULTS

PCR results showed that 90 (56.3%) of P. aeruginosa isolates carried class 1 integron. Antibiotic susceptibility results revealed that 93 (58.1%) were susceptible and 67 (41.9%) were non-susceptible to imipenem. Comparison of antibiotic susceptibility patterns showed high level of drug resistance among imipenem non-susceptible isolates. We found that MDR phenotype, presence of class 1 integron and hospitalization in ICU and burn units were significantly associated with imipenem non-susceptible isolates.

CONCLUSION

The high frequency of imipenem resistance was seen among our P. aeruginosa isolates. Since carbapenems are considered as the last drugs used for treatment of P. aeruginosa infections, it is crucial to screen imipenem non-susceptible isolates in infection control and optimal therapy.

摘要

背景与目的

铜绿假单胞菌是医院感染尤其是重症监护病房(ICU)和烧伤病房最重要的病原体之一。由于对多种抗生素产生获得性耐药,铜绿假单胞菌感染通常难以根除。耐碳青霉烯类铜绿假单胞菌菌株的近期出现被视为一个重大的医疗问题。本研究旨在检测对亚胺培南敏感和耐药的铜绿假单胞菌临床分离株的1类整合子及抗生素敏感性谱。

材料与方法

分别采用纸片琼脂扩散法和Etest法研究了160株铜绿假单胞菌临床分离株的抗生素敏感性谱及对亚胺培南的最低抑菌浓度。采用聚合酶链反应(PCR)法检测1类整合子。运用SPSS软件比较亚胺培南敏感和不敏感分离株的人口统计学和微生物学数据。

结果

PCR结果显示,90株(56.3%)铜绿假单胞菌分离株携带1类整合子。抗生素敏感性结果显示,93株(58.1%)对亚胺培南敏感,67株(41.9%)对亚胺培南不敏感。抗生素敏感性模式比较显示,亚胺培南不敏感分离株的耐药水平较高。我们发现多重耐药表型、1类整合子的存在以及在ICU和烧伤病房住院与亚胺培南不敏感分离株显著相关。

结论

在我们的铜绿假单胞菌分离株中观察到亚胺培南耐药的高频率。由于碳青霉烯类被视为治疗铜绿假单胞菌感染的最后一线药物,在感染控制和优化治疗中筛查亚胺培南不敏感分离株至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35bd/3279778/ec60ad825f3f/IJM-2-115-g001.jpg

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