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检测铜绿假单胞菌临床分离株中的 SHV 型超广谱β-内酰胺酶和危险因素。

Detection of SHV type Extended-Spectrum B-lactamase and Risk Factors in Pseudomonas aeruginosa Clinical Isolates.

机构信息

Nasrin Bahmani, MS, Microbiology Department, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj-Iran.

Rashid Ramazanzadeh, Associated Professor, Cellular and Molecular Research Center, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj-Iran.

出版信息

Pak J Med Sci. 2013 May;29(3):788-92. doi: 10.12669/pjms.293.3263.

Abstract

OBJECTIVE

Pseudomonas aeruginosa is one of the most important causes of nosocomial infections and can acquire resistant to many antimicrobials, including β-lactams. The aim of this study was to detect the prevalence of SHV type extended-spectrum beta-lactamase (ESBL), antimicrobial resistance patterns of the P. aeroginusa and risk factors in hospitalized patients in two teaching hospitals in Sanandaj, Iran.

METHODOLOGY

123 P. aeruginosa were isolated from various clinical specimens. All samples were prepared for double-disk synergy test on the isolates for detection of ESBL. SHV was confirmed by PCR method. Risk factors were evaluated for infection due to P. aeruginosa.

RESULTS

The incidence of multiple drug resistance (MDR) in P. aeroginusa isolates was 3.85%. The prevalence of ESBL-SHV gene was 10.57%. Days of hospitalization (OR=14.34 CI95% 2.87-25.8), ICU hospitalization (OR=3.4 CI95% 1.24- 9.29), presence of catheter (OR=3.63 CI 95% 1.34-9.84), use of antimicrobials within previous two weeks (OR=5.51 CI95% 1.85-16.43) and use of ventilator (OR=3.7557 CI95%1.29-9) were risk factors for Pseudomonas nosocomial infection SHV positive ESBL.

CONCLUSION

In this study Prevalence of ESBL, SHV gene and MDR in P. aeroginosa infection was lower than the prevalence reported from other studies in Iran and this indicated appropriate antimicrobial managements strategies and infection control. In addition, our research data indicate that risk factors such as use of ventilator, use of antimicrobials and ICU hospitalization can be effective in managing Pseudomonas infection.

摘要

目的

铜绿假单胞菌是医院感染的最重要原因之一,并且可以对许多抗生素产生耐药性,包括β-内酰胺类。本研究旨在检测伊朗赞詹省两所教学医院住院患者中铜绿假单胞菌的 SHV 型超广谱β-内酰胺酶(ESBL)流行率、抗菌药物耐药模式和危险因素。

方法

从各种临床标本中分离出 123 株铜绿假单胞菌。对所有样本进行双碟协同试验以检测 ESBL。通过 PCR 方法确认 SHV。评估感染铜绿假单胞菌的危险因素。

结果

铜绿假单胞菌分离株的多药耐药(MDR)发生率为 3.85%。SHV-ESBL 基因的流行率为 10.57%。住院天数(OR=14.34 CI95% 2.87-25.8)、ICU 住院(OR=3.4 CI95% 1.24-9.29)、导管存在(OR=3.63 CI 95% 1.34-9.84)、两周内使用抗生素(OR=5.51 CI95% 1.85-16.43)和使用呼吸机(OR=3.7557 CI95%1.29-9)是铜绿假单胞菌医院感染 SHV 阳性 ESBL 的危险因素。

结论

在这项研究中,铜绿假单胞菌感染中 ESBL、SHV 基因和 MDR 的流行率低于伊朗其他研究报告的流行率,这表明适当的抗菌药物管理策略和感染控制措施是有效的。此外,我们的研究数据表明,使用呼吸机、使用抗生素和 ICU 住院等危险因素可能对管理铜绿假单胞菌感染有效。

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