Ramadan Raghdaa A, Gebriel Manar G, Kadry Heba M, Mosallem Ahmed
Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Sharkia, Egypt,
Anesthesia and Surgical Intensive Care Department, Faculty of Medicine, Zagazig University, Zagazig, Sharkia, Egypt.
Infect Drug Resist. 2018 Aug 22;11:1261-1269. doi: 10.2147/IDR.S170233. eCollection 2018.
Carbapenamase producing and are emerging worldwide limiting the use of carbapenems as effective and safe drugs.
To characterize different carbapenemase genes carried by carbapenem-resistant (CR) and isolates and to evaluate the in vitro effect of some colistin-based combinations by E-test method in Zagazig University Hospitals ICU isolates.
CR and isolated from the surgical intensive care unit (ICU) were tested for carbapenemase genes by polymerase chain reaction and the effect of colistin/meropenem and colistin/tigecycline combinations was evaluated by E-test.
Genes coding for OXA-23, NDM and GES were detected in 90, 66.7 and 50% of CR , respectively, while genes coding for VIM, GES, NDM and IMP were detected in 50, 40.9, 27.3 and 18.2% of CR , respectively. Colistin/tigecycline combination showed synergistic and additive effect in 20% and 60% of isolates, respectively, while colistin/meropenem combination showed synergistic and additive effect in 63.6% and 36.4% of , respectively.
Carbapenemase genes carriage accounts for high level carbapenem resistance in our isolates. Colistin/tigecycline and colistin/meropenem combinations can be considered for treatment of severe infections by CR and , respectively.
产碳青霉烯酶的[细菌名称]在全球范围内不断出现，限制了碳青霉烯类药物作为有效且安全药物的使用。
鉴定耐碳青霉烯类（CR）[细菌名称]分离株携带的不同碳青霉烯酶基因，并通过E-test法评估扎加齐格大学医院重症监护病房（ICU）分离株中一些基于黏菌素的联合用药的体外效果。
通过聚合酶链反应检测从外科重症监护病房（ICU）分离出的CR[细菌名称]的碳青霉烯酶基因，并通过E-test评估黏菌素/美罗培南和黏菌素/替加环素联合用药的效果。
分别在90%、66.7%和50%的CR[细菌名称]中检测到编码OXA-23、NDM和GES的基因，而在分别50%、40.9%、27.3%和18.2%的CR[细菌名称]中检测到编码VIM、GES、NDM和IMP的基因。黏菌素/替加环素联合用药在20%的[细菌名称]分离株中显示协同作用，在60%的分离株中显示相加作用，而黏菌素/美罗培南联合用药在63.6%的[细菌名称]中显示协同作用，在36.4%的[细菌名称]中显示相加作用。
碳青霉烯酶基因携带是我们分离株中高水平耐碳青霉烯的原因。黏菌素/替加环素和黏菌素/美罗培南联合用药可分别考虑用于治疗CR[细菌名称]和[细菌名称]引起的严重感染。
