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[布鲁氏菌属菌株对从血培养物中分离出的11种不同抗菌药物的体外敏感性测定]

[Determination of in vitro susceptibilities of Brucella spp. strains against 11 different antibacterial gents isolated from blood cultures].

作者信息

Keşli Recep, Bilgin Hüseyin, Yılmaz Halim

机构信息

Afyon Kocatepe University Faculty of Medicine, Department of Medical Microbiology, Afyonkarahisar, Turkey.

出版信息

Mikrobiyol Bul. 2017 Jul;51(3):260-268. doi: 10.5578/mb.57362.

Abstract

Brucellosis is a worldwide zoonotic disease and still continuous to be a major public health problem. In this study, it was aimed to identify the Brucella strains to the species level isolated from blood cultures, and to determine the rate of antimicrobial susceptibility against eleven antibacterial agents. A total of 106 Brucella spp. strains were included in the study, which were isolated from blood cultures in University of Health Sciences, Konya Training and Research Hospital, Medical Microbiology Laboratory between January 2011 and June 2013. Identification of the isolated strains were mainly based on conventional methods. In vitro antibacterial susceptibilities of azithromycin, ciprofloxacin, doxycycline, gentamicin, levofloxacin, moxifloxacin, rifampicin, streptomycin, tetracycline, tigecycline, and trimethoprim/sulfamethoxazole, were evaluated by using the gradient (E-test, bioMerieux, France) strip method. The bacterial suspensions adjusted to 0.5 McFarland turbidity was inoculated to Mueller Hinton agar plates, supplemented with 5% sheep blood, and E-test strips of selected antibacterial were applied. The plates were incubated in ambient air 48 hours at 37ºC and Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 29213 were used as quality control strains for antimicrobial susceptibility testing. Minimum inhibitors concentration (MIC) values were interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines for slow-growing bacteria such as Haemophilus spp. Of the 106 Brucella spp. strains included in to the study, 90 were identified as Brucella melitensis, and 16 were Brucella abortus. MIC90 values of azithromycin, ciprofloxacin, doxycycline, gentamicin, levofloxacin, moxifloxacin, rifampicin, streptomycin, tetracycline, tigecycline, and trimethoprim/sulfamethoxazole were determined as 1 µg/ml, 0.25 µg/ml, 0.19 µg/ml, 0.25 µg/ml, 0.19 µg/ml, 0.75 µg/ml, 0.25 µg/ml, 0.75 µg/ml, 0.38 µg/ml, 0.64 µg/ml, and 0.19 µg/ml respectively. According to MIC90 values, gentamicin, moxifloxacin, and trimethoprim/sulfamethoxazole, were the most effective antibacterial agents. All the Brucella strains were sensitive to all the tested antibacterial agents except rifampicin. Only six isolates showed intermediate susceptibility to rifampicin. With regard to fluoroquinolones, the most active antibacterial agent was moxifloxacin, followed by ciprofloxacin and levofloxacin. In our study, no resistance was found for the classically recommended antibacterial agents used in the treatment of Brucella species in our hospital but antibiotic susceptibility patterns of Brucella spp. may vary geographically. As a result it was concluded that, the antimicrobial susceptibilities of Brucella species should be determined and controlled periodically to avoid the possible development of resistance problems in the future.

摘要

布鲁氏菌病是一种全球性人畜共患病,至今仍是一个主要的公共卫生问题。本研究旨在将从血培养中分离出的布鲁氏菌菌株鉴定到种水平,并确定其对11种抗菌药物的药敏率。本研究共纳入106株布鲁氏菌属菌株,这些菌株于2011年1月至2013年6月间从开塞利培训与研究医院大学健康科学部医学微生物实验室的血培养中分离得到。分离菌株的鉴定主要基于传统方法。采用梯度(E-test,法国生物梅里埃公司)纸条法评估阿奇霉素、环丙沙星、多西环素、庆大霉素、左氧氟沙星、莫西沙星、利福平、链霉素、四环素、替加环素和甲氧苄啶/磺胺甲恶唑的体外抗菌敏感性。将调整至0.5麦氏浊度的细菌悬液接种到补充有5%羊血的穆勒-欣顿琼脂平板上,并应用所选抗菌药物的E-test纸条。平板在37℃的环境空气中孵育48小时,大肠埃希菌ATCC 25922和金黄色葡萄球菌ATCC 29213用作抗菌药敏试验的质量控制菌株。最低抑菌浓度(MIC)值根据临床和实验室标准协会(CLSI)针对如嗜血杆菌属等生长缓慢细菌的指南进行判读。在纳入本研究的106株布鲁氏菌属菌株中,90株被鉴定为羊种布鲁氏菌,16株为牛种布鲁氏菌。阿奇霉素、环丙沙星、多西环素、庆大霉素、左氧氟沙星、莫西沙星、利福平、链霉素、四环素、替加环素和甲氧苄啶/磺胺甲恶唑的MIC90值分别确定为1μg/ml、0.25μg/ml、0.19μg/ml、0.25μg/ml、0.19μg/ml、0.75μg/ml、0.25μg/ml、0.75μg/ml、0.38μg/ml、0.64μg/ml和0.19μg/ml。根据MIC90值,庆大霉素、莫西沙星和甲氧苄啶/磺胺甲恶唑是最有效的抗菌药物。除利福平外,所有布鲁氏菌菌株对所有测试抗菌药物均敏感。仅6株分离株对利福平表现为中介敏感性。就氟喹诺酮类药物而言,最具活性的抗菌药物是莫西沙星,其次是环丙沙星和左氧氟沙星。在我们的研究中,我院用于治疗布鲁氏菌属的经典推荐抗菌药物未发现耐药情况,但布鲁氏菌属的抗生素药敏模式可能因地域而异。因此得出结论,应定期确定和控制布鲁氏菌属的抗菌药敏情况,以避免未来可能出现的耐药问题。

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