铜绿假单胞菌金属β-内酰胺酶阳性菌株与金属β-内酰胺酶阴性菌株的流行病学及抗生素敏感性模式比较

Comparison of epidemiological and antibiotic susceptibility pattern of metallo-Beta-lactamase-positive and metallo-Beta-lactamase-negative strains of pseudomonas aeruginosa.

作者信息

Ranjan Shikha, Banashankari Gs, Babu Pr Sreenivasa

机构信息

Department of Microbiology, MS Ramaiah Medical College, Bangalore, Karnataka, India.

出版信息

J Lab Physicians. 2014 Jul;6(2):109-13. doi: 10.4103/0974-2727.141509.

DOI:10.4103/0974-2727.141509

PMID:25328336

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4196357/

Abstract

BACKGROUND

The infections caused by metallo-beta-lactamases (MBLs) producing Pseudomonas aeruginosa are associated with higher rates of mortality, morbidity, and overall healthcare costs compared to non-MBL P. aeruginosa infections.

PURPOSE

To compare the epidemiologic factors and antibiograms of MBL-positive and MBL-negative P. aeruginosa isolates in a tertiary care hospital.

METHODS

In an observational study, from January 2011 to December 2012, all non-duplicate P. aeruginosa isolates were subjected to an antimicrobial sensitivity test against 10 antibiotics of five different classes. All P. aeruginosa strains showing resistance to at least one of the carbapenems were subjected to the MBL-E test. Epidemiological features and antibiograms of MBL-positive and MBL-negative strains were compared and statistically analyzed.

RESULTS

Out of 350 isolates (total sample = 5330) of P. aeruginosa, MBL was detected in 58 isolates by the E-test, resulting in a prevalence of 16.57%. Resistance to most of the antibiotics was significantly higher in the MBL-positive strains with 100% resistance to ciprofloxacin, tobramycin, and meropenem, followed by imipenem (93.10%) and gentamicin (89.66%). The prevalence of multidrug-resistant and pandrug-resistant strains was significantly higher among the MBL group as compared to that in the non-MBL group ((55.17 vs. 7.88% (P < 0.0001) and 8.62 vs. 0.68% (P = 0.0006)), respectively.

CONCLUSIONS

MBL-positive P. aeruginosa strains showed very high resistance to various antibiotics, as compared to the non-MBL strains. Increasing prevalence of MBL-producing isolates in hospital settings makes it important to perform routine detection of MBL-positive P. aeruginosa strains by in vitro testing before antibiotic use, for the purposes of infection prevention, and control, and for minimizing the adverse outcomes of infections with MBL-producing strains.

摘要

背景

与非产金属β-内酰胺酶（MBL）的铜绿假单胞菌感染相比，产MBL的铜绿假单胞菌引起的感染与更高的死亡率、发病率及总体医疗费用相关。

目的

比较一家三级护理医院中产MBL和不产MBL的铜绿假单胞菌分离株的流行病学因素及抗菌谱。

方法

在一项观察性研究中，2011年1月至2012年12月期间，所有非重复的铜绿假单胞菌分离株均接受针对5类10种抗生素的药敏试验。所有对至少一种碳青霉烯类抗生素耐药的铜绿假单胞菌菌株均进行MBL-E试验。比较并统计分析产MBL和不产MBL菌株的流行病学特征及抗菌谱。

结果

在350株铜绿假单胞菌分离株（总样本数=5330）中，通过E试验检测出58株产MBL，患病率为16.57%。产MBL菌株对大多数抗生素的耐药性显著更高，对环丙沙星、妥布霉素和美罗培南的耐药率为100%，其次是亚胺培南（93.10%）和庆大霉素（89.66%）。与非MBL组相比，MBL组中多重耐药和泛耐药菌株的患病率显著更高（分别为55.17%对7.88%（P<0.0001）和8.62%对0.68%（P=0.0006））。