Mushi Martha F, Mshana Stephen E, Imirzalioglu Can, Bwanga Freddie
Department of Microbiology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania ; Department of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
Department of Microbiology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.
Biomed Res Int. 2014;2014:303104. doi: 10.1155/2014/303104. Epub 2014 Feb 24.
The burden of antimicrobial resistance (AMR) is rapidly growing across antibiotic classes, with increased detection of isolates resistant to carbapenems. Data on the prevalence of carbapenem resistance in developing countries is limited; therefore, in this study, we determined the prevalence of carbapenemase genes among multidrug resistant gram negative bacteria (MDR-GNB) isolated from clinical specimens in a tertiary hospital in Mwanza, Tanzania. A total of 227 MDR-GNB isolates were analyzed for carbapenem resistance genes. For each isolate, five different PCR assays were performed, allowing for the detection of the major carbapenemase genes, including those encoding the VIM-, IMP-, and NDM-type metallo-beta-lactamases, the class A KPC-type carbapenemases, and the class D OXA-48 enzyme. Of 227 isolates, 80 (35%) were positive for one or more carbapenemase gene. IMP-types were the most predominant gene followed by VIM, in 49 (21.59%) and 28 (12%) isolates, respectively. Carbapenemase genes were most detected in K. pneumoniae 24 (11%), followed by P. aeruginosa 23 (10%), and E. coli with 19 isolates (8%). We have demonstrated for the first time a high prevalence of MDR-GNB clinical isolates having carbapenem resistance genes in Tanzania. We recommend routine testing for carbapenem resistance among the MDR-GNB particularly in systemic infections.
抗菌药物耐药性（AMR）的负担在各类抗生素中迅速增加，对碳青霉烯类耐药菌株的检测也有所增加。关于发展中国家碳青霉烯类耐药性流行情况的数据有限；因此，在本研究中，我们确定了从坦桑尼亚姆万扎一家三级医院的临床标本中分离出的多重耐药革兰氏阴性菌（MDR - GNB）中碳青霉烯酶基因的流行情况。共对227株MDR - GNB分离株进行了碳青霉烯耐药基因分析。对每株分离株进行了五种不同的PCR检测，以检测主要的碳青霉烯酶基因，包括编码VIM型、IMP型和NDM型金属β - 内酰胺酶的基因、A类KPC型碳青霉烯酶基因以及D类OXA - 48酶基因。在227株分离株中，80株（35%）一种或多种碳青霉烯酶基因呈阳性。IMP型是最主要的基因，分别在49株（21.59%）和28株（12%）分离株中检测到，其次是VIM型。碳青霉烯酶基因在肺炎克雷伯菌中检出最多，为24株（11%），其次是铜绿假单胞菌23株（10%），大肠杆菌19株（8%）。我们首次证明了坦桑尼亚MDR - GNB临床分离株中碳青霉烯耐药基因的高流行率。我们建议对MDR - GNB进行碳青霉烯耐药性的常规检测，特别是在系统性感染中。
