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从医院感染和非医院感染患者中分离出的产金属β-内酰胺酶菌株的表型和分子学调查

Phenotypic and Molecular Survey of Metallo-beta-lactamase-producing Isolated from Patients with Nosocomial and Non- Nosocomial Infections.

作者信息

Rouhi Samaneh, Ramazanzadeh Rashid

机构信息

Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran.

Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.

出版信息

Infect Disord Drug Targets. 2020;20(1):56-64. doi: 10.2174/1871526519666190119113328.

Abstract

BACKGROUND

Resistance to antimicrobial agents in Pseudomonas aeruginosa (P. aeruginosa) including carbapenems is a prominent problem in patients. The aim of this study is surveying Metallo-beta-lactamase (MBL)-producing P. aeruginosa isolated from patient specimens with nosocomial and non-nosocomial infections in Kurdistan province, Iran.

METHODS

In total, 146 Pseudomonas spp. were collected (December 2015 to August 2017). P. aeruginosa isolates were detected by phenotypic and polymerase chain reactions (PCR) of gyrB gene. Combination disk (CD) phenotypic test was used for the identification of MBL-producing strains and PCR was applied for identification of blaIMP and blaVIM genes in P. aeruginosa. Sensitivity and specificity of phenotypic tests were calculated as well. Fisher's exact test and logistic regression were used for data analysis (p≤0.05).

RESULTS

A total of 134 (91.78%) and 133 (91.09%) P. aeruginosa were detected using PCR and the phenotypic test, respectively. Fifty-six (41.79%) clinical isolates were isolated from patients with nosocomial infection. CD test proved that 67 out of 134 (50%) P. aeruginosa isolates were positive for MBL, of which 11 (8.20%) carried blaIMP gene. No significant relationship was found between MBL-producing P. aeruginosa and blaIMP genes; as well as between MBL-producing P. aeruginosa and blaIMP genes with age, sex, city of residence, inpatient/outpatient and specimen's type (p≥0.05).

CONCLUSION

Presence of MBL-producing P. aeruginosa strains and blaIMP genes were proved in this study; thus more precaution should be taken in the administration of carbapenem antibiotics to patients.

摘要

背景

铜绿假单胞菌对包括碳青霉烯类在内的抗菌药物产生耐药性是患者面临的一个突出问题。本研究的目的是调查从伊朗库尔德斯坦省医院感染和非医院感染患者标本中分离出的产金属β-内酰胺酶(MBL)的铜绿假单胞菌。

方法

共收集了146株假单胞菌属菌株(2015年12月至2017年8月)。通过表型和gyrB基因的聚合酶链反应(PCR)检测铜绿假单胞菌分离株。采用组合纸片(CD)表型试验鉴定产MBL菌株,并应用PCR鉴定铜绿假单胞菌中的blaIMP和blaVIM基因。还计算了表型试验的敏感性和特异性。采用Fisher精确检验和逻辑回归进行数据分析(p≤0.05)。

结果

分别使用PCR和表型试验检测到134株(91.78%)和133株(91.09%)铜绿假单胞菌。56株(41.79%)临床分离株来自医院感染患者。CD试验证明,134株铜绿假单胞菌分离株中有67株(50%)MBL呈阳性,其中11株(8.20%)携带blaIMP基因。产MBL的铜绿假单胞菌与blaIMP基因之间;以及产MBL的铜绿假单胞菌和blaIMP基因与年龄、性别、居住城市、住院/门诊和标本类型之间均未发现显著相关性(p≥0.05)。

结论

本研究证实了产MBL的铜绿假单胞菌菌株和blaIMP基因的存在;因此,在给患者使用碳青霉烯类抗生素时应采取更多预防措施。

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