bla(OXA-23)、ISAba、氨基糖苷类耐药基因在伊朗德黑兰和萨里烧伤及重症监护病房患者中的分布情况。
Distribution of bla(OXA-23), ISAba , Aminoglycosides resistant genes among burned & ICU patients in Tehran and Sari, Iran.
作者信息
Nasrolahei Mohtaram, Zahedi Bahador, Bahador Abbas, Saghi Hossein, Kholdi Soudeh, Jalalvand Neda, Esmaeili Davoud
机构信息
Department of Microbiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Departments of Microbiology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
Ann Clin Microbiol Antimicrob. 2014 Sep 25;13:38. doi: 10.1186/s12941-014-0038-0.
BACKGROUND
Multidrug resistant strains of Acinetobacter baumannii (MDR-AB) have emerged as alarming nosocomial pathogens among patients admitted to Intensive Care Unit and burned patients. The aim of this study was to determine the susceptibility of A. baumannii isolates, the carbapenems resistance patterns bla(OXA-23) and also ISAba elements of A. baumannii isolates among burned and ICU patients in Tehran and Sari, Iran.
METHODS
In this study, 100 A. baumannii isolates from burned and ICU patients in Tehran and Sari (Iran) during 2013 were tested for determination of antimicrobials susceptibility by the disc-diffusion method on Mueller Hinton agar recommended by the guidelines of Clinical and Laboratory Standards Institute (CLSI), and frequency bla(OXA-23) carbapenemase genes, and insertion elements ISAba genes were studied by PCR method.
RESULTS
The highest rates of susceptibility were observed with Colistin (88.7%), Tigecycline (82.2%), Imipenem (67%) and ISAba (32.2%). The extensively drug-resistance and pan drug-resistance were observed in 37.1% and 8.1% isolates, respectively. Results indicated among isolates resistant to Aminoglycoside and Carbapenem, the highest resistance was observed to Streptomycin (90%) ' and the most sensitivity was to Imipenem (67%).
CONCLUSIONS
This is the most study that attempted to detect Acinetobacter baumanii the insertion elements ISAba , bla(OXA-23) and aminoglycosides resistance in MDR-AB isolates from burned and ICU patients in Iran. In a timely manner, antimicrobial resistance surveillance and strict infection control strategies are still lacking in burn ward and ICU in Iran, despite the alarming emergence of MDR-AB strains, particularly among those isolates that are not susceptible to Colistin. The results of this study are consistent with a recent report in which a number of combinations exhibited potent activity against Multidrug resistant strains of A. baumannii (MDR-AB).
背景
鲍曼不动杆菌多重耐药菌株（MDR-AB）已成为重症监护病房患者和烧伤患者中令人担忧的医院病原体。本研究的目的是确定伊朗德黑兰和萨里烧伤患者和重症监护病房患者中鲍曼不动杆菌分离株的药敏性、碳青霉烯类耐药模式bla(OXA-23)以及鲍曼不动杆菌分离株的ISAba元件。
方法
在本研究中，2013年期间从伊朗德黑兰和萨里的烧伤患者和重症监护病房患者中分离出100株鲍曼不动杆菌，按照临床和实验室标准协会（CLSI）指南推荐的方法，采用纸片扩散法在穆勒-欣顿琼脂上测定其抗菌药敏性，并用PCR法研究bla(OXA-23)碳青霉烯酶基因和插入元件ISAba基因的频率。
结果
观察到对多粘菌素的药敏率最高（88.7%），其次是替加环素（82.2%）、亚胺培南（67%）和ISAba（32.2%）。分别在37.1%和8.1%的分离株中观察到广泛耐药和泛耐药。结果表明，在对氨基糖苷类和碳青霉烯类耐药的分离株中，对链霉素的耐药率最高（90%），对亚胺培南的敏感性最高（67%）。
结论
这是在伊朗烧伤患者和重症监护病房的MDR-AB分离株中检测鲍曼不动杆菌插入元件ISAba、bla(OXA-23)和氨基糖苷类耐药性的最大规模研究。尽管MDR-AB菌株惊人地出现，特别是在那些对多粘菌素不敏感的分离株中，但伊朗的烧伤病房和重症监护病房仍然缺乏及时的抗菌药物耐药性监测和严格的感染控制策略。本研究结果与最近的一份报告一致，该报告指出一些联合用药对鲍曼不动杆菌多重耐药菌株（MDR-AB）具有强效活性。
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