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沙特阿拉伯利雅得临床尿路致病性分离株多重耐药性和超广谱β-内酰胺酶携带情况的患病率

Prevalence of Multidrug Resistance and Extended-Spectrum -Lactamase Carriage of Clinical Uropathogenic Isolates in Riyadh, Saudi Arabia.

作者信息

Alqasim Abdulaziz, Abu Jaffal Ahmad, Alyousef Abdullah A

机构信息

Microbiology Research Group, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia.

Department of Clinical Laboratory Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

出版信息

Int J Microbiol. 2018 Sep 16;2018:3026851. doi: 10.1155/2018/3026851. eCollection 2018.

Abstract

The prevalence of extended-spectrum -lactamase-producing (ESBL-producing ) has recently increased worldwide. This study aims at determining the antimicrobial susceptibility patterns of a collection of clinical urine isolates and evaluating the ESBL carriage of these isolates at phenotypic and genotypic levels. A total of 100 urine isolates were collected at a tertiary healthcare centre in Riyadh from January 2018 to March 2018. Antimicrobial susceptibility testing was carried out for all isolates. ESBL production was characterized at phenotypic and genotypic levels using double-disc synergy test and polymerase chain reaction, respectively. Detection of different ESBL variants was performed using DNA sequencing. Of 100 isolates, 67 were associated with multidrug resistance (MDR) phenotype. All isolates showed variable resistance levels to all antibiotics used here expect to imipenem, where they were all imipenem-sensitive. 33 out of 100 isolates were positive for ESBLs by phenotypic and genotypic methods. Among all ESBL-positive isolates, the CTX-M was the most prevalent ESBL type (31/33 isolates; 93.94%). CTX-M-15 variant was detected in all isolates associated with CTX-M carriage. Multiple ESBL gene carriage was detected in 15/33 isolates (45.45%), where 11 (33.33%) isolates produced two different ESBL types while 4 isolates (12.12%) associated with carrying three different ESBL types. Our study documented the high antimicrobial resistance of ESBL-producing to many front-line antibiotics currently used to treat UTI patients, and this implies the need to continuously revise the local guidelines used for optimal empirical therapy for UTI patients. It also showed the high prevalence of ESBL carriage in urine isolates, with CTX-M-15 being the most predominant CTX-M variant.

摘要

产超广谱β-内酰胺酶(ESBL)细菌的流行率近来在全球范围内有所上升。本研究旨在确定一批临床尿液分离株的抗菌药敏模式,并在表型和基因型水平评估这些分离株的ESBL携带情况。2018年1月至2018年3月期间,在利雅得的一家三级医疗中心共收集了100株尿液分离株。对所有分离株进行了抗菌药敏试验。分别使用双纸片协同试验和聚合酶链反应在表型和基因型水平对ESBL产生情况进行了鉴定。使用DNA测序检测不同的ESBL变体。在100株分离株中,67株与多重耐药(MDR)表型相关。除亚胺培南外,所有分离株对这里使用的所有抗生素均表现出不同程度的耐药,所有分离株对亚胺培南均敏感。通过表型和基因型方法,100株分离株中有33株ESBL呈阳性。在所有ESBL阳性分离株中,CTX-M是最常见的ESBL类型(31/33株分离株;93.94%)。在所有携带CTX-M的分离株中均检测到CTX-M-15变体。在33株分离株中有15株(45.45%)检测到多种ESBL基因携带情况,其中11株(33.33%)分离株产生两种不同的ESBL类型,4株(12.12%)分离株携带三种不同的ESBL类型。我们的研究记录了产ESBL细菌对目前用于治疗UTI患者的许多一线抗生素具有高度耐药性,这意味着需要不断修订用于UTI患者最佳经验性治疗的当地指南。研究还显示尿液分离株中ESBL携带率很高,CTX-M-15是最主要的CTX-M变体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b412/6165594/b383d4728fc7/IJMICRO2018-3026851.001.jpg

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