Ben Helal Rania, Dziri Raoudha, Chedly Meriem, Klibi Naouel, Barguellil Farouk, El Asli Mohamed Selim, Ben Moussa Mohamed
1 Service of Microbiology, Military Hospital of Tunis HMPIT , Tunis, Tunisia .
2 Laboratory of Microorganisms and Active Biomolecules, Faculty of Sciences of Tunis, University of Tunis El Manar , Tunis, Tunisia .
Microb Drug Resist. 2018 Nov;24(9):1361-1367. doi: 10.1089/mdr.2018.0013. Epub 2018 Mar 29.
Carbapenem-resistant Enterobacteriaceae have become of particular concern, since they were quickly disseminated in various areas in the world. The aim of the study was to investigate the prevalence of carbapenemase production among clinical isolates of Enterobacteriaceae recovered from the Military Hospital of Tunisia. Bacterial isolates (n = 125) were recovered from patients in diverse services from March 2014 to February 2016 and identified by Vitek II Compact. The multiplex PCR for bla, bla, bla, bla, and bla with subsequent amplicon detection by reverse hybridization was performed with the Hyplex SuperBug ID test system (AmplexDiagnostics GmbH, Gars-Bahnhof, Germany). The 125 strains showed resistance to carbapenems of which 102 strains (81.6%) were carbapenemase-producing Enterobacteriaceae and were identified as Klebsiella pneumoniae (85.2%), Enterobacter cloacae (9.8%), Escherichia coli (2.9%), Providencia stuartii (0.9%) and Enterobacter aerogenes (0.9%). These strains were isolated mainly from blood, anal, and urine samples. Patients were mainly hospitalized in the intensive care units, surgery, and medical services. All strains were resistant to ertapenem (100%) and 55.8% showed resistance to imipenem. Carbapenemases genes detected in our study were as follows: bla (84 isolates), bla (8 isolates), bla + bla (5 isolates), and bla + bla (5 isolates). Our research provides epidemiological data showing the quick spread of carbapenem-resistant bacteria in our region, which calls for new surveillance strategies and strict hygiene rules.
耐碳青霉烯类肠杆菌科细菌已成为特别令人关注的问题，因为它们在世界各个地区迅速传播。本研究的目的是调查从突尼斯军事医院分离的肠杆菌科临床分离株中产碳青霉烯酶的情况。2014年3月至2016年2月期间，从不同科室的患者中分离出细菌分离株（n = 125），并通过Vitek II Compact进行鉴定。使用Hyplex SuperBug ID测试系统（德国加尔斯-巴nhof的AmplexDiagnostics GmbH）进行bla、bla、bla、bla和bla的多重PCR，随后通过反向杂交检测扩增子。125株菌株对碳青霉烯类耐药，其中102株（81.6%）为产碳青霉烯酶的肠杆菌科细菌，鉴定为肺炎克雷伯菌（85.2%）、阴沟肠杆菌（9.8%）、大肠埃希菌（2.9%）、斯氏普罗威登斯菌（0.9%）和气生肠杆菌（0.9%）。这些菌株主要从血液、肛门和尿液样本中分离出来。患者主要住院于重症监护病房、外科和内科。所有菌株对厄他培南均耐药（100%），55.8%对亚胺培南耐药。本研究中检测到的碳青霉烯酶基因如下：bla（84株）、bla（8株）、bla + bla（5株）和bla + bla（5株）。我们的研究提供了流行病学数据，表明耐碳青霉烯类细菌在我们地区迅速传播，这需要新的监测策略和严格的卫生规则。
