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印度一家三级护理医院社区获得性感染中β-内酰胺酶的共存情况

Coexistence of -Lactamases in Community-Acquired Infections in a Tertiary Care Hospital in India.

作者信息

Mirza Shahzad, Jadhav Savita, Misra R N, Das Nikunja Kumar

机构信息

Department of Microbiology, Dr., D. Y. Patil Medical College Hospital and Research Centre, Pimpri, Pune 18, India.

出版信息

Int J Microbiol. 2019 Dec 11;2019:7019578. doi: 10.1155/2019/7019578. eCollection 2019.

Abstract

INTRODUCTION

The trends of -lactamases producing is ever increasing, and limited studies have reported investigating coexistence of lactamases in . A cross-sectional study after approval from the Institutional Ethical committee was conducted between June 2014 and May 2016 in community-acquired infections due to multidrug-resistant organisms in our tertiary care. Nonrepetitive clinical samples from the out-patient department (OPD) were processed for bacteriological culture and identification of An antibiotic susceptibility test, screening, and phenotypic confirmation for ESBLs and carbapenemases and AmpC producers were performed to check for coexistence of these enzymes.

RESULTS

Nonrepetitive clinical specimens processed for culture and identification in our hospital revealed 417 positive isolates in community acquired infections which were multidrug-resistant organisms, and on screening for -lactamases, 293 isolates were positive for one of the three beta lactamases, ESBL, AmpC, or carbapnemases. Coproduction of ESBL and MBL was seen in 5 isolates, 35 isolates showed coproduction of ESBL and AmpC enzymes, and AmpC and MBL coproduction was exhibited in only in 5 isolates.

CONCLUSIONS

Coexistence of ESBLs, AmpC producers, and carbapenemases has been described. Continuous monitoring and surveillance and proper infection control and prevention practices will limit the further spread of these superbugs within the hospital and beyond.

摘要

引言

产β-内酰胺酶的趋势不断增加,且仅有有限的研究报道了对β-内酰胺酶在[具体对象未明确]中共存情况的调查。在获得机构伦理委员会批准后,于2014年6月至2016年5月在我们三级医疗机构对社区获得性多重耐药菌感染进行了一项横断面研究。对门诊(OPD)的非重复性临床样本进行细菌培养及[具体细菌未明确]鉴定。进行了抗生素敏感性试验、超广谱β-内酰胺酶(ESBLs)、碳青霉烯酶和AmpC酶的筛选及表型确认,以检查这些酶的共存情况。

结果

在我院进行培养和鉴定的非重复性临床标本显示,在社区获得性感染中有417株阳性分离株为多重耐药菌,在筛选β-内酰胺酶时,293株分离株对三种β-内酰胺酶(ESBL、AmpC或碳青霉烯酶)之一呈阳性反应。5株分离株同时产ESBL和金属β-内酰胺酶(MBL),35株分离株同时产ESBL和AmpC酶,仅5株分离株同时产AmpC和MBL。

结论

已描述了ESBLs、AmpC酶生产者和碳青霉烯酶的共存情况。持续监测和监督以及适当的感染控制和预防措施将限制这些超级细菌在医院内外的进一步传播。

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