Farshadzadeh Zahra, Khosravi Azar Dokht, Alavi Seyed Mohammad, Parhizgari Najmeh, Hoveizavi Hajar
Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Burns. 2014 Dec;40(8):1575-80. doi: 10.1016/j.burns.2014.02.008. Epub 2014 Apr 22.
Pseudomonas aeruginosa is resistant to many antibiotics due to production of different classes of extended spectrum β-lactamases (ESBLs). Prevalence of ESBLs among P. aeruginosa has been increased in recent years, demonstrate a serious health problem especially in burn units worldwide.
Present study was designed to determine the ESBL producing strains and identify the genes encoding three different ESBLs of bla PER-1, bla OXA-10 and bla CTX-M genes in P. aeruginosa isolates from burn patients.
In total 185 clinical isolates of P. aeruginosa were collected from infectious wounds of hospitalized burn patients. Antimicrobial susceptibility testing and phenotypic detection of ESBL were performed by disk diffusion method and Double disk Synergy Test (DDST). Polymerase Chain Reaction (PCR) was done for detection of bla OXA-10, bla PER-1 and bla CTX-M ESBL encoding genes.
In total, 176 (95.13%) isolates were multidrug resistant. The DDST demonstrated 96 (51.9%) isolates as putative ESBL producers with 100% or highly resistance to ofloxacin, cephalexin, aztreonam (97.57%) and ceftriaxone (91.6%). By PCR amplification, bla PER-1, bla OXA-10 and bla CTX-M genes were detected in 52 (54.16%), 66 (68.75%) and 1 (1.04%) isolates of ESBL producers respectively. Forty-three isolates (44.79%) were simultaneously positive for both bla OXA-10 and bla PER-1 related genes.
The rate of ESBL producing P. aeruginosa was notable in present study. Since there are only limited effective antibiotics against the bacterium, therefore all isolates must be investigated by antimicrobial susceptibility testing, which limits resistance development in burn units and helps the management of treatment strategy.
铜绿假单胞菌由于产生不同类型的超广谱β-内酰胺酶(ESBLs)而对多种抗生素耐药。近年来,铜绿假单胞菌中ESBLs的流行率有所上升,这在全球范围内尤其是烧伤病房中显示出一个严重的健康问题。
本研究旨在确定产ESBLs菌株,并鉴定烧伤患者分离出的铜绿假单胞菌中编码三种不同ESBLs(bla PER-1、bla OXA-10和bla CTX-M基因)的基因。
从住院烧伤患者的感染伤口共收集了185株铜绿假单胞菌临床分离株。采用纸片扩散法和双纸片协同试验(DDST)进行抗菌药物敏感性测试和ESBL的表型检测。采用聚合酶链反应(PCR)检测bla OXA-10、bla PER-1和bla CTX-M ESBL编码基因。
总共176株(95.13%)分离株对多种药物耐药。DDST显示96株(51.9%)分离株为推定的ESBL生产者,对氧氟沙星、头孢氨苄、氨曲南(97.57%)和头孢曲松(91.6%)具有100%或高度耐药性。通过PCR扩增,在产ESBLs分离株中分别检测到bla PER-1、bla OXA-10和bla CTX-M基因,分别为52株(54.16%)、66株(68.75%)和1株(1.04%)。43株(44.79%)分离株同时对bla OXA-10和bla PER-1相关基因呈阳性。
本研究中产ESBLs的铜绿假单胞菌比例显著。由于针对该细菌的有效抗生素有限,因此所有分离株都必须通过抗菌药物敏感性测试进行调查,这有助于限制烧伤病房中的耐药性发展并有助于治疗策略的管理。