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埃及一家三级护理医院重症监护病房出现新型多重耐药鲍曼不动杆菌序列型。

The emergence of a novel sequence type of MDR Acinetobacter baumannii from the intensive care unit of an Egyptian tertiary care hospital.

作者信息

Ghaith Doaa Mohammad, Zafer Mai Mahmoud, Al-Agamy Mohamed Hamed, Alyamani Essam J, Booq Rayan Y, Almoazzamy Omar

机构信息

Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.

Department of Microbiology and Immunology, Faculty of Pharmacy, Ahram Canadian University, Giza, Egypt.

出版信息

Ann Clin Microbiol Antimicrob. 2017 May 10;16(1):34. doi: 10.1186/s12941-017-0208-y.

Abstract

BACKGROUND AND AIM OF WORK

Acinetobacter baumannii is known for nosocomial outbreaks worldwide. In this study, we aimed to investigate the antibiotic susceptibility patterns and the clonal relationship of A. baumannii isolates from the intensive care unit (ICU) of an Egyptian hospital.

METHODS

In the present study, 50 clinical isolates of multidrug resistant (MDR)-A. baumannii were obtained from patients admitted into the ICU from June to December 2015. All isolates were analyzed for antimicrobial susceptibilities. Multiplex PCR was performed to detect genes encoding oxacillinase genes (bla -like, bla -like, bla -like, and bla -like). Multilocus sequence typing (MLST) based on the seven-gene scheme (gltA, gyrB, gdhB, recA, cpn60, gpi, rpoD) was used to examine these isolates.

RESULTS

All A. baumannii clinical isolates showed the same resistance pattern, characterized by resistance to most common antibiotics including imipenem (MIC ≥ 8μ/mL), with the only exception being colistin. Most isolates were positive for bla -like and bla -like (100 and 96%, respectively); however, bla -like and bla -like were not detected. MLST analysis identified different sequence types (ST195, ST208, ST231, ST441, ST499, and ST723) and a new sequence type (ST13929) with other sporadic strains.

CONCLUSIONS

MDR A. baumannii strains harboring bla -like genes were widely circulating in this ICU. MLST was a powerful tool for identifying and epidemiologically typing our strains. Strict infection control measures must be implemented to contain the worldwide spread of MDR A. baumannii in ICUs.

摘要

工作背景与目的

鲍曼不动杆菌以在全球范围内引起医院感染暴发而闻名。在本研究中,我们旨在调查埃及一家医院重症监护病房(ICU)分离出的鲍曼不动杆菌菌株的抗生素敏感性模式及克隆关系。

方法

在本研究中,从2015年6月至12月入住ICU的患者中获取了50株多重耐药(MDR)鲍曼不动杆菌临床分离株。对所有分离株进行抗菌药物敏感性分析。进行多重PCR以检测编码奥沙西林酶基因(bla - 样、bla - 样、bla - 样和bla - 样)的基因。基于七基因方案(gltA、gyrB、gdhB、recA、cpn60、gpi、rpoD)的多位点序列分型(MLST)用于检测这些分离株。

结果

所有鲍曼不动杆菌临床分离株均表现出相同的耐药模式,其特征为对包括亚胺培南(MIC≥8μg/mL)在内的大多数常用抗生素耐药,唯一例外是黏菌素。大多数分离株bla - 样和bla - 样呈阳性(分别为100%和96%);然而,未检测到bla - 样和bla - 样。MLST分析鉴定出不同的序列类型(ST195、ST208、ST231、ST441、ST499和ST723)以及一种新的序列类型(ST13929)和其他散在菌株。

结论

携带bla - 样基因 的MDR鲍曼不动杆菌菌株在该ICU中广泛传播。MLST是鉴定我们的菌株并进行流行病学分型的有力工具。必须实施严格的感染控制措施以遏制MDR鲍曼不动杆菌在ICU中的全球传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9948/5424338/39b47082a047/12941_2017_208_Fig1_HTML.jpg

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