Peymani A, Naserpour-Farivar T, Zare E, Azarhoosh K H
Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
J Prev Med Hyg. 2017 Jun;58(2):E155-E160.
Pseudomonas aeruginosa is as an important opportunistic human pathogen, which is associated with several clinical infections that are usually difficult to treat because of resistance to multiple antimicrobials. The production of extendedspectrum ß-lactamases (ESBLs) is an important mechanism of ß-lactam resistance. The aims of this study were to determine the prevalence of ESBLs, antimicrobial susceptibility, and to detect the bla, bla, and bla genes.
In this study, carried out from March 2013 to December 2014, 266 P. aeruginosa isolates were collected from patients admitted to teaching hospitals of Qazvin and Tehran, Iran. All isolates were initially screened for ESBL production by disk diffusion method and were further confirmed using a combined disk method. Antimicrobial susceptibility of ESBL-producing isolates was determined by standard disk diffusion method. Polymerase Chain Reaction (PCR) and sequencing techniques were employed for detection of bla, bla, and bla genes.
In total, 262 (98.5%) P. aeruginosa isolates were nonsusceptible to the used extended spectrum cephalosporins, and, among these, 75 (28.6%) isolates were ESBL producers. Fifty-nine (78.7%) of ESBL-producing isolates showed multidrug-resistance pattern. Of 75 ESBL-positive isolates, the bla (26.7%) was the most common gene, followed by bla (17.3%), bla (6.7%), and bla (4%), either alone or in combination.
The results of this study showed the notable prevalence of ESBLs among the clinical isolates of P. aeruginosa in Iran, indicating the urgency for the implementation of appropriate follow-up measures for infection control and proper administration of antimicrobial agents in our medical settings.
铜绿假单胞菌是一种重要的人类机会致病菌,与多种临床感染相关,由于对多种抗菌药物耐药,这些感染通常难以治疗。超广谱β-内酰胺酶(ESBLs)的产生是β-内酰胺耐药的重要机制。本研究的目的是确定ESBLs的流行率、抗菌药物敏感性,并检测bla、bla和bla基因。
本研究于2013年3月至2014年12月进行,从伊朗加兹温市和德黑兰市教学医院收治的患者中收集了266株铜绿假单胞菌分离株。所有分离株最初采用纸片扩散法筛选ESBLs产生情况,并进一步用复合纸片法进行确认。产ESBLs分离株的抗菌药物敏感性通过标准纸片扩散法测定。采用聚合酶链反应(PCR)和测序技术检测bla、bla和bla基因。
总共262株(98.5%)铜绿假单胞菌分离株对所用的超广谱头孢菌素不敏感,其中75株(28.6%)分离株产ESBLs。59株(78.7%)产ESBLs分离株呈现多重耐药模式。在75株ESBL阳性分离株中,bla(26.7%)是最常见的基因,其次是bla(17.3%)、bla(6.7%)和bla(4%),这些基因单独或组合存在。
本研究结果显示伊朗临床分离的铜绿假单胞菌中ESBLs的流行率显著,表明在我们的医疗环境中实施适当的感染控制后续措施和合理使用抗菌药物的紧迫性。