FarajzadehSheikh Ahmad, Veisi Hojat, Shahin Mojtaba, Getso Muhammad, Farahani Abbas
1Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
2Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Trop Med Health. 2019 Mar 4;47:19. doi: 10.1186/s41182-019-0147-8. eCollection 2019.
As an opportunistic pathogen, () is widely recognized as the main cause of nosocomial infections as well as some disorders especially those associated with urinary tract infections (UTIs). This study, therefore, sets out to determine the extent of antibiotic resistance to quinolones and to measure the frequency of genes (A, B, and S) within extended-spectrum beta-lactamase (ESBL) and non-ESBL-producing strains of isolated from UTI-diagnosed patients as well as to investigate their antimicrobial susceptibility patterns for some selected antibiotics in southwest Iran.
Two hundred strains were isolated from UTI-diagnosed patients, hospitalized in nine different wards of Ahvaz Golestan Hospital between November 2015 and March 2016. The isolates were confirmed through well-practiced phenotypical methods. Moreover, the antimicrobial susceptibility test was successfully performed using a disk diffusion method. ESBL production among the isolates was screened by double disk synergism test (DDST), and the genes were identified using a multiplex PCR.
Out of the 200 samples collected, 167 isolates were confirmed to be strains. Maximum and minimum resistance were reported against nalidixic acid and chloramphenicol with 65.3% and 17.4%, respectively. Most of the isolates were resistant to all three types of quinolones studied in this research. Using multiplex PCR, the genes were found in 100 (59.88%) strains (A = 10, B = 21, S = 41, B-S = 21, B-A = 1, A-S = 3, A-B-S = 3), 58% of which was found among ESBL-producing isolates.
Resistance to quinolones antibiotics was highest among ESBL-producing isolates harboring, especially S among other determinants of the gene. There is a need for sensitive antibiotic stewardship especially in hospitals of Ahvaz, Khuzestan province. Further research is needed to ascertain the gravity of quinolones resistance in Iran and to quickly act against its spread among other nosocomial pathogens.
作为一种机会致病菌，（）被广泛认为是医院感染以及一些疾病尤其是与尿路感染（UTIs）相关疾病的主要病因。因此，本研究旨在确定对喹诺酮类抗生素的耐药程度，并测定从尿路感染确诊患者中分离出的产超广谱β-内酰胺酶（ESBL）和不产ESBL的（）菌株中（A、B和S）基因的频率，以及调查它们对伊朗西南部一些选定抗生素的抗菌药敏模式。
2015年11月至2016年3月期间，从阿瓦士戈勒斯坦医院九个不同病房住院的尿路感染确诊患者中分离出200株（）菌株。通过成熟的表型方法对分离株进行确认。此外，使用纸片扩散法成功进行了抗菌药敏试验。通过双纸片协同试验（DDST）筛选分离株中产ESBL的情况，并使用多重PCR鉴定（）基因。
在收集的200个样本中，167株分离株被确认为（）菌株。对萘啶酸和氯霉素的耐药率最高和最低，分别为65.3%和17.4%。大多数分离株对本研究中研究的所有三种喹诺酮类药物耐药。使用多重PCR，在100株（59.88%）菌株中发现了（）基因（A = 10，B = 21，S = 41，B-S = 21，B-A = 1，A-S = 3，A-B-S = 3），其中58%在产ESBL的分离株中发现。
在携带（）基因的产ESBL分离株中，尤其是在该基因的其他决定因素中S基因，对喹诺酮类抗生素的耐药性最高。尤其在胡齐斯坦省阿瓦士的医院中，需要进行敏感的抗生素管理。需要进一步研究以确定伊朗喹诺酮类耐药的严重程度，并迅速采取行动防止其在其他医院病原体中传播。
