Zorgani Abdulaziz, Almagatef Asma, Sufya Najib, Bashein Abdulla, Tubbal Abdullatif
Medical Microbiology, Faculty of Medicine, University of Tripoli, Tripoli, Libya.
Microbiology Department, Faculty of Pharmacy, University of Tripoli, Tripoli, Libya.
Oman Med J. 2017 Jul;32(4):322-327. doi: 10.5001/omj.2017.61.
Multidrug resistance (MDR) and emergence of extended-spectrum β-lactamases (ESBLs) among uropathogenic have been reported worldwide, but there was no information on the detection of in major teaching hospitals in Libya. The aim of the study was to investigate the occurrence of CTX-M-15 β-lactamases producers isolated from five teaching hospitals in Tripoli, Libya.
A total of 346 urine samples were collected from hospitalized patients in five teaching hospitals with a diagnosis of urinary tract infection (UTI). Phenotypic confirmation of ESBLs was confirmed by E-test strip; all ESBL-producing isolates were screened for the gene.
The distribution of ESBL-producing varied among the five hospitals. The highest proportion was identified in Tripoli Medical Centre (67.6%). There were extremely high proportions of isolates resistant to ceftriaxone, cefepime, and ceftazidime (93.0-100.0%) among ESBL producers compared to non-ESBL producers (2.2-4.7%). MDR was detected in 22.2% of isolates. The majority of isolates (85.9%) in which was identified were ESBL producers. There was a correlation ( < 0.001) between expression of CTX-M-15 and resistance to ceftazidime.
The isolation of MDR ESBL-producing uropathogens expressing the CTX-M-15 gene will limit the choices clinicians have to treat their patients with UTIs. Continued surveillance and implementation of efficient infection control measures are required.
全球范围内已报道了尿路致病性细菌中的多重耐药性（MDR）和超广谱β-内酰胺酶（ESBLs）的出现，但利比亚主要教学医院中关于此类细菌的检测尚无相关信息。本研究的目的是调查从利比亚的黎波里五家教学医院分离出的产CTX-M-15β-内酰胺酶细菌的发生情况。
从五家教学医院中诊断为尿路感染（UTI）的住院患者中总共收集了346份尿液样本。通过E-test试纸条对ESBLs进行表型确认；对所有产ESBLs的细菌分离株进行CTX-M-15基因筛查。
五家医院中产ESBLs细菌的分布有所不同。在的黎波里医疗中心发现的比例最高（67.6%）。与非产ESBLs细菌（2.2%-4.7%）相比，产ESBLs细菌中对头孢曲松、头孢吡肟和头孢他啶耐药的分离株比例极高（93.0%-100.0%）。在22.2%的分离株中检测到MDR。鉴定出CTX-M-15的大多数分离株（85.9%）是产ESBLs细菌。CTX-M-15的表达与对头孢他啶的耐药性之间存在相关性（P<0.001）。
分离出表达CTX-M-15基因的产MDR ESBLs尿路致病性细菌将限制临床医生治疗UTI患者的选择。需要持续监测并实施有效的感染控制措施。
