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伊朗住院患者中产NDM-1的耐黏菌素分子流行病学研究。

Molecular epidemiology of colistin-resistant producing NDM-1 from hospitalized patients in Iran.

作者信息

Farajzadeh Sheikh Ahmad, Shahin Mojtaba, Shokoohizadeh Leili, Halaji Mehrdad, Shahcheraghi Fereshteh, Ghanbari Fahimeh

机构信息

Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Iran J Basic Med Sci. 2019 Jan;22(1):38-42. doi: 10.22038/ijbms.2018.29264.7096.

Abstract

OBJECTIVES

Resistance to carbapenems is the principal reason for the continuing utilization of colistin as a last resort choice for treating the infections resulted from multidrug carbapenem-resistant (CRPA) isolates. The assessment of antimicrobial resistance pattern, the prevalence of carbapenem-resistance determinants, and molecular epidemiology of colistin-resistant isolates among CRPA strains were the aims of the present research.

MATERIALS AND METHODS

The current cross-sectional research was conducted on 269 CRPA isolates collected from various clinical samples from 2013 to 2016. After performing identification tests, disk diffusion as well as MIC methods were used for testing sensitivity to the antibiotics. Modified Hodge Test (MHT) was utilized to produce carbapenemase. PCR technique identified beta-lactamase classes A, B, and D genes.

RESULTS

In total, from 269 CRPA, five isolates (1.3%) were resistant to colistin. It was found that , and genes were present in 40%, 40%, 20%, and 100% of colistin-resistant isolates, respectively. DLST type 25-11 is a significant cluster of colistin-resistant isolates.

CONCLUSION

The appearance of colistin-resistant isolates in CRPA carrying NDM-1 with multiple carbapenem-resistant genes shows the great problem in the treatment of infections.

摘要

目的

对碳青霉烯类耐药是继续将黏菌素作为治疗多重耐药碳青霉烯类耐药(CRPA)菌株所致感染的最后选择的主要原因。本研究的目的是评估CRPA菌株中抗菌药物耐药模式、碳青霉烯类耐药决定因素的流行情况以及黏菌素耐药菌株的分子流行病学。

材料与方法

本横断面研究对2013年至2016年从各种临床样本中收集的269株CRPA菌株进行。在进行鉴定试验后,采用纸片扩散法和MIC法检测对抗生素的敏感性。采用改良 Hodge试验(MHT)检测碳青霉烯酶。PCR技术鉴定A、B、D类β-内酰胺酶基因。

结果

在总共269株CRPA菌株中,有5株(1.3%)对黏菌素耐药。发现blaNDM-1、blaOXA-48、blaVIM和blaIMP基因分别存在于40%、40%、20%和100%的黏菌素耐药菌株中。ST25-11型是黏菌素耐药菌株的一个重要聚类。

结论

携带NDM-1且具有多个碳青霉烯类耐药基因的CRPA菌株中出现黏菌素耐药菌株,表明在治疗CRPA感染方面存在重大问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b16/6437460/366877deaaf9/IJBMS-22-038-g001.jpg

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