Farhan Sara M, Ibrahim Reham A, Mahran Khaled M, Hetta Helal F, Abd El-Baky Rehab M
Department of Microbiology and Immunology, Faculty of Pharmacy, Deraya University, Minia 11566, Egypt.
Department of Microbiology and Immunology, Faculty of Pharmacy, Minia University, Minia 61519 Egypt.
Infect Drug Resist. 2019 Jul 16;12:2125-2133. doi: 10.2147/IDR.S198373. eCollection 2019.
() represents a great threat to public health worldwide, due to its high ability to acquire resistance to different antibiotic classes. Carbapenems are effective against multidrug resistant (MDR) but their widespread use has resulted in the emergence of carbapenem-resistant strains, which is considered a major global concern. This study aimed to determine the prevalence of carbapenem resistance among strains isolated from different sites of infection. Between October 2016 and February 2018, a total of 530 clinical specimens were collected from patients suffering from different infections, then processed and cultured. Isolates were tested for extended spectrum β-lactamase (ESBL) and metallo-β-lactamase (MBL) production using double-disk synergy test, modified Hodge tests, and disc potentiation test. PCR was used for the detection of selected OXA carbapenemases encoding genes. Of 530 samples, 150 (28.3%) isolates were obtained. MDR strains were found in 66.6% (100 of 150) of isolates. Of 100 MDR isolates, 54 (54%) were ESBL producers and 21 (21%) carbapenem resistant . MBL production was found in 52.3% (eleven) carbapenem-resistant isolates. CTX-M15 was found among 55.5% of ESBL- producing . Carbapenemase genes detected were (42.8%, nine of 21), (52.3%, eleven of 21), (52.3%, eleven of 21), (38%, 8/21). In addition, isolates that were positive for the tested genes showed high resistance to other antimicrobials, such as colistin sulfate and tigecycline. Our study indicates that harboring ESBL and MBL with limited sensitivity to antibiotics are common among the isolated strains, which indicates the great problem facing the treatment of serious infectious diseases. As such, there is a need to study the resistance patterns of isolates and carry out screening for the presence of ESBL and MBL enzymes, in order to choose the proper antibiotic.
（）由于其对不同抗生素类别产生耐药性的能力很强，对全球公共卫生构成了巨大威胁。碳青霉烯类药物对多重耐药（MDR）有效，但它们的广泛使用导致了耐碳青霉烯类菌株的出现，这被视为一个主要的全球问题。本研究旨在确定从不同感染部位分离的菌株中耐碳青霉烯类的流行情况。在2016年10月至2018年2月期间，共从患有不同感染的患者中收集了530份临床标本，然后进行处理和培养。使用双纸片协同试验、改良 Hodge试验和纸片增效试验对分离株进行超广谱β-内酰胺酶（ESBL）和金属β-内酰胺酶（MBL）产生情况的检测。PCR用于检测选定的OXA碳青霉烯酶编码基因。在530份样本中，获得了150株（28.3%）分离株。在66.6%（150株中的100株）的分离株中发现了MDR菌株。在100株MDR分离株中，54株（54%）是ESBL产生菌，21株（21%）对碳青霉烯类耐药。在52.3%（11株）耐碳青霉烯类的分离株中发现了MBL产生情况。在55.5%的ESBL产生菌中发现了CTX-M15。检测到的碳青霉烯酶基因有blaKPC（42.8%，21株中的9株）、blaNDM（52.3%，21株中的11株）、blaIMP（52.3%，21株中的11株）、blaVIM（38%，21株中的8株）。此外，对检测基因呈阳性的分离株对其他抗菌药物，如硫酸黏菌素和替加环素也表现出高度耐药性。我们的研究表明，携带ESBL和MBL且对抗生素敏感性有限的情况在分离株中很常见，这表明在治疗严重传染病方面面临着巨大问题。因此，有必要研究分离株的耐药模式并对ESBL和MBL酶的存在进行筛查，以便选择合适的抗生素。
