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埃塞俄比亚非发酵革兰氏阴性杆菌中多重耐药性和超广谱β-内酰胺酶产生的高流行率

High Prevalence of Multi-Drug Resistance and Extended Spectrum Beta Lactamase Production in Non-Fermenting Gram-Negative Bacilli in Ethiopia.

作者信息

Bitew Adane

机构信息

Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

Infect Dis (Auckl). 2019 Nov 5;12:1178633719884951. doi: 10.1177/1178633719884951. eCollection 2019.

Abstract

BACKGROUND

Emergence of resistance to multiple antimicrobial agents in Non-Fermenting Gram-Negative Bacilli is a major problem to public health, as it limits drug treatment options against infections. The aim of this study was to determine the prevalence of multi-drug resistance and extended spectrum beta lactamase production in Non-Fermenting Gram-Negative Bacilli.

MATERIALS AND METHODS

Different clinical samples were collected and processed following standard procedures. Each sample was then inoculated onto culture media. Identification, drug susceptibility testing, and extended spectrum beta lactamase production of the isolates were carried out by using the VITEK 2 compact system.

RESULTS

Among 996 clinical samples, 135 samples yielded Non-Fermenting Gram-Negative Bacilli of which and species were the commonest isolates. The overall drug resistance rates of Non-Fermenting Gram-Negative Bacilli were above 80% against ampicillin (89.6%), cefuroxime axetil (88.9%), nitrofurantoin (85.9%), cefalotin (84.4%), cefoxitin (83.7%), cefazolin (83.0%), and cefuroxime (83.0%). Tobramycin with a resistance rate of 19.3% was the most active antimicrobial agent. Out of 135 isolates, 81.5% were multi-drug resistant of which 13.3% were extensively drug resistant and 10.4% were pandrug resistant. Extended spectrum beta lactamase production was detected in 48.9% of the isolates.

CONCLUSIONS

The spectrum of bacterial species isolated was diverse. The isolates demonstrated high level of drug resistance in different classes of antibiotics. The magnitude of multi-drug resistance and the level of extended spectrum beta lactamase production were high. Hence, further studies on multi-drug resistant and extended spectrum beta lactamase producing Non-Fermenting Gram-Negative Bacilli both in the community and in hospital setting are essential.

摘要

背景

非发酵革兰氏阴性杆菌对多种抗菌药物产生耐药性已成为公共卫生领域的一个主要问题,因为这限制了针对感染的药物治疗选择。本研究的目的是确定非发酵革兰氏阴性杆菌中多重耐药性和超广谱β-内酰胺酶产生的流行情况。

材料与方法

按照标准程序收集并处理不同的临床样本。然后将每个样本接种到培养基上。使用VITEK 2 compact系统对分离株进行鉴定、药敏试验和超广谱β-内酰胺酶产生情况检测。

结果

在996份临床样本中,有135份样本分离出非发酵革兰氏阴性杆菌,其中[具体菌名1]和[具体菌名2]是最常见的分离株。非发酵革兰氏阴性杆菌对氨苄西林(89.6%)、头孢呋辛酯(88.9%)、呋喃妥因(85.9%)、头孢噻吩(84.4%)、头孢西丁(83.7%)、头孢唑林(83.0%)和头孢呋辛(83.0%)的总体耐药率均高于80%。耐药率为19.3%的妥布霉素是最有效的抗菌药物。在135株分离株中,81.5%为多重耐药,其中13.3%为广泛耐药,10.4%为全耐药。48.9%的分离株检测到超广谱β-内酰胺酶产生。

结论

分离出的细菌种类多样。这些分离株在不同类别的抗生素中表现出高水平的耐药性。多重耐药性的程度和超广谱β-内酰胺酶产生的水平都很高。因此,对社区和医院环境中产生多重耐药和超广谱β-内酰胺酶的非发酵革兰氏阴性杆菌进行进一步研究至关重要。

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