Gholami Mehrdad, Moshiri Mona, Ahanjan Mohammad, Salimi Chirani Alireza, Hasannejad Bibalan Meysam, Asadi Arezoo, Eshaghi Morteza, Pournajaf Abazar, Abbasian Sara, Kouhsari Ebrahim, Irajian Gholamreza
Department of Microbiology and Virology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Pathobiology, Division of Microbiology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Infez Med. 2018 Dec 1;26(4):329-335.
Wide distrubution of multidrug-resistant Acinetobacter baumannii strains has become a foremost concern in hospital environments. Treatment of infections caused by multidrug resistant strains has conventionally involved the use of β-lactams such as carbapenems. In this study, we report the distribution of carbapenemase genes in A. baumannii isolated from hospitalized patients. The study was conducted on 110 non-repetitive A. baumannii isolates collected from hospitalized patients, over a nine-month period. Clinical isolates were examined by conventional susceptibility testing, using the disk-diffusion method and multiplex polymerase chain reaction to detect acquired carbapenemase genes. All of the isolates were completely resistant to TOB, SXT, IPM, MEM, CTX, CRO, FEP, CAZ, CIP, PTZ, PIP and were susceptible to colistin, but moderately susceptible TET (2.72%), AK (4.54%) and GEN (3.63%). The prevalence of bla-OXA-51like, bla-OXA-23like, bla-OXA-24like, bla-OXA-58like, blaSIM and blaSPM genes was 100%, 96.36%, 35.45%, 7.27%, 7.27% and 3.63%, respectively. bla-GIM and bla-VIM genes were not detected among the strains. Our results suggest that OXA-type carbapenemase genes plus class B β-lactamases contribute to carbapenem resistance in the collected isolates. Therefore, quick identification of these resistant genes using molecular approaches is critical in limiting the spread of infections caused by A. baumannii. Drug administration correction of the physicians, based on antibiotic susceptibility testing and more knowledge on the nosocomial infection control policies as essential need.
多重耐药鲍曼不动杆菌菌株的广泛传播已成为医院环境中最主要的关注点。由多重耐药菌株引起的感染治疗传统上涉及使用碳青霉烯类等β-内酰胺类药物。在本研究中,我们报告了从住院患者中分离出的鲍曼不动杆菌中碳青霉烯酶基因的分布情况。该研究对在九个月期间从住院患者中收集的110株非重复鲍曼不动杆菌分离株进行。通过传统药敏试验、纸片扩散法和多重聚合酶链反应对临床分离株进行检测,以检测获得性碳青霉烯酶基因。所有分离株对妥布霉素、复方新诺明、亚胺培南、美罗培南、头孢噻肟、头孢曲松、头孢吡肟、头孢他啶、环丙沙星、哌拉西林/他唑巴坦、哌拉西林均完全耐药,对黏菌素敏感,但对四环素(2.72%)、庆大霉素(4.54%)和吉米沙星(3.63%)中度敏感。bla-OXA-51-like、bla-OXA-23-like,、bla-OXA-24-like、bla-OXA-58-like、blaSIM和blaSPM基因的流行率分别为100%、96.36%、35.45% =、7.27%、7.27%和3.63%。在这些菌株中未检测到bla-GIM和bla-VIM基因。我们的结果表明,OXA型碳青霉烯酶基因加上B类β-内酰胺酶导致了所收集分离株对碳青霉烯类的耐药性。因此,使用分子方法快速鉴定这些耐药基因对于限制鲍曼不动杆菌引起的感染传播至关重要。根据抗生素药敏试验对医生的用药进行校正,并更多地了解医院感染控制政策是必不可少的需求。