Mishra Shyam Kumar, Rijal Basista Prasad, Pokhrel Bharat Mani
Department of Microbiology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
BMC Res Notes. 2013 Mar 15;6:98. doi: 10.1186/1756-0500-6-98.
Infections caused by bacteria such as multidrug resistant (MDR) Acinetobacter spp. and methicillin-resistant Staphylococcus aureus (MRSA) constitute a worldwide pandemic. Without gathering information about these strains, we cannot reduce the morbidity and mortality due to infections caused by these notorious bugs.
This study was conducted to identify the status of MDR Acinetobacter spp. and MRSA in a tertiary care centre of Nepal. Sputum, endotracheal aspirate and bronchial washing specimens were collected and processed from patients suspected of lower respiratory tract infection following standard microbiological methods recommended by the American Society for Microbiology (ASM). Double disk synergy test method was employed for the detection of extended-spectrum beta-lactamase (ESBL) in Acinetobacter isolates. Methicillin resistance in S. aureus was confirmed by using cefoxitin and oxacillin disks.
Different genomespecies of Acinetobacter were isolated; these consisted of Acinetobacter calcoaceticus baumannii complex and A. lwoffii. Around 95% of Acinetobacter isolates were MDR, while 12.9% were ESBL-producer. Of the total 33 isolates of S. aureus, 26 (78.8%) were MDR and 14 (42.4%) were methicillin resistant.
A large number of MDR Acinetobacter spp. and MRSA has been noted in this study. The condition is worsened by the emergence of ESBL producing Acinetobacter spp. Hence, judicious use of antimicrobials is mandatory in clinical settings. Moreover, there should be vigilant surveillance of resistant clones in laboratories.
由多重耐药(MDR)不动杆菌属和耐甲氧西林金黄色葡萄球菌(MRSA)等细菌引起的感染构成了全球性大流行。如果不收集有关这些菌株的信息,我们就无法降低由这些臭名昭著的病菌引起的感染的发病率和死亡率。
本研究旨在确定尼泊尔一家三级护理中心中多重耐药不动杆菌属和MRSA的状况。按照美国微生物学会(ASM)推荐的标准微生物学方法,从疑似下呼吸道感染的患者中收集痰液、气管内吸出物和支气管冲洗标本并进行处理。采用双纸片协同试验法检测不动杆菌分离株中的超广谱β-内酰胺酶(ESBL)。使用头孢西丁和苯唑西林纸片确认金黄色葡萄球菌中的耐甲氧西林情况。
分离出了不动杆菌的不同基因组种;这些包括醋酸钙鲍曼不动杆菌复合体和洛菲不动杆菌。约95%的不动杆菌分离株为多重耐药,而12.9%为产ESBL菌株。在总共33株金黄色葡萄球菌分离株中,26株(78.8%)为多重耐药,14株(42.4%)耐甲氧西林。
本研究中发现了大量多重耐药不动杆菌属和MRSA。产ESBL不动杆菌属的出现使情况更加恶化。因此,临床环境中必须合理使用抗菌药物。此外,实验室应对耐药克隆进行警惕的监测。