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从伊朗马尔卡齐省免疫功能低下和健康患者中分离出的机会性放线菌的物种多样性、分子特征及药敏性

Species Diversity, Molecular Characterization, and Antimicrobial Susceptibility of Opportunistic Actinomycetes Isolated from Immunocompromised and Healthy Patients of Markazi Province of Iran.

作者信息

Azadi Davood, Motallebirad Tahereh, Ghaffari Kazem, Shokri Dariuosh, Rezaei Fatemeh

机构信息

Department of Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran.

Molecular Medicine Research Center, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran.

出版信息

Infect Drug Resist. 2020 Jan 7;13:1-10. doi: 10.2147/IDR.S234292. eCollection 2020.

Abstract

BACKGROUND

Actinomycetes widely exist in nature and these species cause infections in immunocompromised and healthy patients, although they are frequently found as members of the normal microbiota of humans and animals. These subsequent infections are often misdiagnosed as malignancy and tuberculosis. Due to this issue, the present study aimed to determine the presence and diversity of actinomycetes species causing infections in Iranian patients.

MATERIALS AND METHODS

A total of 79 clinical samples collected from five hospitals in Markazi province were analyzed for the existence of actinomycetes using standard protocols for isolation and characterization of the isolates. The conventional tests were used for preliminary identification, the PCR amplification of 65 gene, the specific region of the 16S rRNA, and sequence analyses of 16S rRNA were applied for the genus and species identification. MICs of the antimicrobial agent were determined by the broth microdilution method and interpreted according to the NCCLS guidelines.

RESULTS

A total of 17 (21.51%) actinomycetes isolates were recovered from clinical samples. In other analyzed samples, eight (10.12%) gram-positive, 12 (15.18) gram-negative bacteria, and six (7.6) fungi isolates were recovered. The most prevalent actinomycetes species were (17.64%), and (11.76% each), and 10 species, ie, . , , , and made up the single isolates. Results of DST illustrated that all of the isolates were susceptible to Amikacin, Levofloxacin, Ofloxacin, and Ciprofloxacin, whereas all of them were resistant to Rifampicin and Doxycycline.

CONCLUSION

In conclusion, increasing isolation of actinomycetes found in various clinical cases merits special attention by health authorities in developing countries. In health centers, action should be taken to increase awareness of appropriate diagnostic criteria and management guidelines for actinomycetes diseases. Furthermore, an increase in the number as well as the quality of national and regional reference laboratories may facilitate more accurate diagnosis of actinomycetes diseases.

摘要

背景

放线菌广泛存在于自然界,尽管它们常作为人类和动物正常微生物群的成员被发现,但这些菌种会在免疫功能低下和健康的患者中引发感染。这些后续感染常常被误诊为恶性肿瘤和结核病。鉴于此问题,本研究旨在确定导致伊朗患者感染的放线菌种类的存在情况和多样性。

材料与方法

从马尔卡齐省五家医院收集了79份临床样本,使用分离菌株和鉴定菌株的标准方案分析放线菌的存在情况。采用常规试验进行初步鉴定,对65个基因、16S rRNA的特定区域进行PCR扩增,并对16S rRNA进行序列分析以鉴定属和种。通过肉汤微量稀释法测定抗菌剂的最低抑菌浓度(MIC),并根据美国国家临床实验室标准委员会(NCCLS)指南进行解释。

结果

从临床样本中总共分离出17株(21.51%)放线菌。在其他分析样本中,分离出8株(10.12%)革兰氏阳性菌、12株(15.18%)革兰氏阴性菌和6株(7.6%)真菌。最常见的放线菌种类是[具体菌种1](17.64%)、[具体菌种2]和[具体菌种3](各占11.76%),还有10种,即[具体菌种4]、[具体菌种5]、[具体菌种6]、[具体菌种7]、[具体菌种8]、[具体菌种9]、[具体菌种10]、[具体菌种11]、[具体菌种12]和[具体菌种13]构成单一分离株。药敏试验结果表明,所有分离株对阿米卡星、左氧氟沙星、氧氟沙星和环丙沙星敏感,而对利福平和多西环素均耐药。

结论

总之,在各种临床病例中放线菌分离率的增加值得发展中国家的卫生当局特别关注。在卫生中心,应采取行动提高对放线菌病适当诊断标准和管理指南的认识。此外,增加国家和地区参考实验室的数量以及提高其质量可能有助于更准确地诊断放线菌病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77b0/6954848/12874cfb7cef/IDR-13-1-g0001.jpg

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