Ethiopian Public Health Institute, Clinical Bacteriology and Mycology Research Case Team, Addis Ababa, Ethiopia.
Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
PLoS One. 2019 Sep 25;14(9):e0222911. doi: 10.1371/journal.pone.0222911. eCollection 2019.
The emergence of multidrug-resistance (MDR), production of extended-spectrum β-lactamases, and carbapenemase in members of fermentative gram-negative bacilli are a serious threat to public health.
The aim of this study was to determine the burden of multi-drug resistance, the production of extended-spectrum β-lactamases (ESBLs), and carbapenemase in fermentative Gram-negative bacilli in Ethiopian Public Health Institute.
A cross-sectional study was carried out from December 2017 to June 2018. Different clinical samples were collected, inoculated, and incubated according to standard protocols related to each sample. Bacterial identification was performed by using the VITEKR 2 compact system using the GNR card. Antimicrobial susceptibility testing was carried out by the Kirby-Bauer disc diffusion method. Production of ESBL and carbapenemase were confirmed by combination disc and modified Hodge Test method respectively.
A total of 238 fermentative Gram-negative bacilli were recovered during the study period, among which E.coli were the predominant isolates followed by K. pneumoniae. The highest percentage of antibiotic resistance was noted against ampicillin (100%) followed by trimethoprim/sulfamethoxazole (81.9%). The isolates showed better sensitivity towards carbapenem drugs. Out of 238 isolates, 94.5% were MDR and of which 8.8% and 0.8% were extensively and pan drug resistant, respectively. Nearly 67% and 2% of isolates were producers of ESBL and carbapenemase, respectively. The isolation rates of MDR, ESBL, and carbapenemase producing stains of the isolates were ≥70% in intensive care unit while the isolation rates in other wards were ≤25%.
The findings of this study revealed that the burden of MDR and ESBL was high and carbapenemase producing isolates were also identified which is concerning. This situation warrants a consistent surveillance of antimicrobial resistance of fermentative Gram-negative bacilli and implementation of an efficient infection control program.
产超广谱β-内酰胺酶（ESBL）和碳青霉烯酶的多重耐药（MDR）在发酵革兰氏阴性杆菌成员中出现，这对公共健康构成了严重威胁。
本研究旨在确定埃塞俄比亚公共卫生研究所发酵革兰氏阴性杆菌的多药耐药、产 ESBL 和碳青霉烯酶的负担。
一项横断面研究于 2017 年 12 月至 2018 年 6 月进行。根据与每个样本相关的标准方案，收集、接种和孵育不同的临床样本。使用 GNR 卡的 VITEKR 2 紧凑型系统进行细菌鉴定。采用 Kirby-Bauer 圆盘扩散法进行抗菌药物敏感性试验。通过联合圆盘和改良 Hodge 试验法分别确认 ESBL 和碳青霉烯酶的产生。
在研究期间共分离出 238 株发酵革兰氏阴性杆菌，其中大肠埃希菌是主要分离株，其次是肺炎克雷伯菌。对氨苄西林（100%）的抗生素耐药率最高，其次是磺胺甲恶唑/甲氧苄啶（81.9%）。这些分离株对碳青霉烯类药物的敏感性较好。在 238 株分离株中，94.5%为 MDR，其中 8.8%和 0.8%分别为广泛耐药和全耐药。近 67%和 2%的分离株分别为 ESBL 和碳青霉烯酶的产生者。在重症监护病房，MDR、ESBL 和碳青霉烯酶产生菌的分离率≥70%，而其他病房的分离率≤25%。
本研究结果表明，MDR 和 ESBL 的负担很高，并且还鉴定出了产碳青霉烯酶的分离株，这令人担忧。这种情况需要对发酵革兰氏阴性杆菌的抗菌药物耐药性进行持续监测，并实施有效的感染控制计划。
