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耐碳青霉烯类铜绿假单胞菌:与毒力基因及生物膜形成的关联

Carbapenem-resistant Pseudomonas aeruginosa: association with virulence genes and biofilm formation.

作者信息

Rossi Gonçalves Iara, Dantas Raquel Cristina Cavalcanti, Ferreira Melina Lorraine, Batistão Deivid William da Fonseca, Gontijo-Filho Paulo Pinto, Ribas Rosineide Marques

机构信息

Universidade Federal de Uberlândia, Instituto de Ciências Biomédicas, Laboratório de Microbiologia, Uberlândia, MG, Brazil.

Universidade Federal de Uberlândia, Instituto de Ciências Biomédicas, Laboratório de Microbiologia, Uberlândia, MG, Brazil.

出版信息

Braz J Microbiol. 2017 Apr-Jun;48(2):211-217. doi: 10.1016/j.bjm.2016.11.004. Epub 2016 Nov 26.

Abstract

Pseudomonas aeruginosa is an opportunistic pathogen that causes frequently nosocomial infections, currently becoming more difficult to treat due to the various resistance mechanisms and different virulence factors. The purpose of this study was to determine the risk factors independently associated with the development of bacteremia by carbapenem-resistant P. aeruginosa, the frequency of virulence genes in metallo-β-lactamases producers and to evaluate their ability to produce biofilm. We conducted a case-control study in the Uberlândia Federal University - Hospital Clinic, Brazil. Polymerase Chain Reaction was performed for metallo-β-lactamases and virulence genes. Adhesion and biofilm assays were done by quantitative tests. Among the 157 strains analyzed, 73.9% were multidrug-resistant, 43.9% were resistant to carbapenems, 16.1% were phenotypically positive for metallo-β-lactamases, and of these, 10.7% were positive for bla gene and 5.3% positive for bla. The multivariable analysis showed that mechanical ventilation, enteral/nasogastric tubes, primary bacteremia with unknown focus, and inappropriate therapy were independent risk factors associated with bacteremia. All tested strains were characterized as strongly biofilm producers. A higher mortality was found among patients with bacteremia by carbapenem-resistant P. aeruginosa strains, associated independently with extrinsic risk factors, however it was not evident the association with the presence of virulence and metallo-β-lactamases genes.

摘要

铜绿假单胞菌是一种机会致病菌,常引起医院感染,由于其多种耐药机制和不同的毒力因子,目前治疗变得越来越困难。本研究的目的是确定与耐碳青霉烯类铜绿假单胞菌所致菌血症发生独立相关的危险因素、金属β-内酰胺酶产生菌中毒力基因的频率,并评估其形成生物膜的能力。我们在巴西乌贝兰迪亚联邦大学医院诊所进行了一项病例对照研究。对金属β-内酰胺酶和毒力基因进行了聚合酶链反应。通过定量试验进行黏附及生物膜检测。在分析的157株菌株中,73.9%为多重耐药,43.9%对碳青霉烯类耐药,16.1%金属β-内酰胺酶表型阳性,其中10.7% bla基因阳性,5.3% bla阳性。多变量分析显示,机械通气、肠内/鼻胃管、原发灶不明的原发性菌血症及不恰当治疗是与菌血症相关的独立危险因素。所有检测菌株均被鉴定为强生物膜产生菌。耐碳青霉烯类铜绿假单胞菌所致菌血症患者的死亡率较高,与外在危险因素独立相关,然而,毒力和金属β-内酰胺酶基因的存在与之并无明显关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/542a/5470431/3c090178e7a9/gr1.jpg

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