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尼日利亚埃努古市儿科人群中多重耐药性及影响产超广谱β-内酰胺酶肠杆菌科细菌携带的因素

Multi-Antibiotic Resistance and Factors Affecting Carriage of Extended Spectrum β-Lactamase-Producing Enterobacteriaceae in Pediatric Population of Enugu Metropolis, Nigeria.

作者信息

Oli Angus N, Ogbuagu Vitalis I, Ejikeugwu Chika P, Iroha Ifeanyichukwu R, Ugwu Malachy C, Ofomata Chijioke M, Okeke Kenneth N, Emechebe George O, Okoro Jude C, Okani Chukwudi O, Onah Stanley K

机构信息

Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, P.M.B 5025, Anambra State, Nigeria.

Department of Applied Microbiology, Faculty of Science, Ebonyi State University, Abakaliki, P.M.B 053, Ebonyi State, Nigeria.

出版信息

Med Sci (Basel). 2019 Nov 17;7(11):104. doi: 10.3390/medsci7110104.

Abstract

Extended-spectrum β-lactamase (ESBL)-producing organisms have become a serious challenge in healthcare delivery globally. The prevalence of ESBL carriage in healthy and sick children in Enugu, Nigeria, was bacteriologically investigated in this study. Four hundred and twenty-two biological samples (mid-stream urine and feces) were bacteriologically analyzed. The isolates were screened for ESBL production using Clinical and Laboratory Standards Institute (CLSI) breakpoints. The suspected ESBL producers were confirmed using double disc synergy test method. Out of the 162 isolates screened, 32 (19.8%) were confirmed as ESBL positive, with a prevalence of 25.32% among sick children in Enugu State University Teaching Hospital (ESUTH), Parklane, Enugu and 13.89% in apparently healthy children in a community setting. spp. and had the highest prevalence of 34.6% and 28.6%, respectively; spp. and spp. were 18.2% and 16.7%, respectively. The ESBL positive isolates were resistant to sulfamethoxazole/trimethoprim (100%), tetracycline (100%), kanamycin (96.9%), nitrofurantoin (84.4%), ciprofloxacin (68.6%), and chloramphenicol (62.5%) but susceptible to meropenem (100%), colistin (56.3%), and gentamicin (50%). spp. had the highest ESBL occurrence among sick children while had the highest ESBL occurrence among healthy children in Enugu. All ESBL-positive isolates were multiply resistant to conventional antibiotics. The emergence and spread of β-lactamase-producing Enterobacteriaceae in hospital and community environments highlight the possibility for an infection outbreak if not checked.

摘要

产超广谱β-内酰胺酶(ESBL)的微生物已成为全球医疗保健领域的一项严峻挑战。本研究对尼日利亚埃努古市健康及患病儿童中ESBL携带情况进行了细菌学调查。对422份生物样本(中段尿和粪便)进行了细菌学分析。使用临床和实验室标准协会(CLSI)的断点标准对分离菌株进行ESBL产生情况筛查。采用双纸片协同试验方法对疑似产ESBL菌株进行确认。在筛查的162株分离菌株中,32株(19.8%)被确认为ESBL阳性,在埃努古州立大学教学医院(ESUTH)、埃努古帕克巷的患病儿童中患病率为25.32%,在社区环境中看似健康的儿童中患病率为13.89%。某菌属和另一菌属的患病率最高,分别为34.6%和28.6%;另一菌属和另一菌属分别为18.2%和16.7%。ESBL阳性分离菌株对磺胺甲恶唑/甲氧苄啶(100%)、四环素(100%)、卡那霉素(96.9%)、呋喃妥因(84.4%)、环丙沙星(68.6%)和氯霉素(62.5%)耐药,但对美罗培南(100%)、黏菌素(56.3%)和庆大霉素(50%)敏感。某菌属在患病儿童中ESBL发生率最高,而另一菌属在埃努古市健康儿童中ESBL发生率最高。所有ESBL阳性分离菌株对传统抗生素均呈现多重耐药。医院和社区环境中产β-内酰胺酶肠杆菌科细菌的出现和传播凸显了若不加以控制则可能爆发感染的可能性。

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