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黏菌素对携带blaOXA - 23样和blaOXA - 24样基因的多重耐药鲍曼不动杆菌分离株的体外活性:一项基于多中心的研究。

In vitro activity of colistin against multidrug-resistant Acinetobacter baumannii isolates harboring blaOXA-23-like and blaOXA-24-like genes: A multicenter based study.

作者信息

Khanjani Susan, Sedigh Ebrahim-Saraie Hadi, Shenagari Mohammad, Ashraf Ali, Mojtahedi Ali, Atrkar Roushan Zahra

机构信息

1Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

2Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

Acta Microbiol Immunol Hung. 2020 Mar 9;67(3):182-186. doi: 10.1556/030.2020.01031.

Abstract

This study was aimed to evaluate occurrence of antibiotic resistance and the presence of resistance determinants among clinical isolates of Acinetobacter baumannii. This cross-sectional study from January to September 2018 was performed on 59 A. baumannii strains isolated from clinical samples in the north of Iran. Isolates were identified by standard microbiologic tests and molecular method. Antimicrobial susceptibility testing was carried out by disk diffusion and broth microdilution methods. The presence of carbapenem resistance genes was detected by PCR method. All isolates were resistant to cefepime, meropenem, imipenem and ceftazidime. The lowest resistance rate was observed against doxycycline with 33.9%. Minimum inhibitory concentration (MIC) results showed that all carbapenem-resistant A. baumannii (CRAB) isolates were susceptible to colistin with MIC50 and MIC90 values of 1/2 µg/mL. Among 59 CRAB, blaOXA-23-like was the most prevalent gene (86.4%) followed by blaOXA-24-like (69.5%). Meanwhile, none of the clinical isolates harbored blaOXA-58-like gene. We found a high prevalence of CRAB strains harboring OXA-type carbapenemases in the north of Iran. Our results suggests that the presence of OXA-type genes was not directly correlated with the increase of imipenem MIC level, but can be clinically important as they contribute to the selection of CRAB strains.

摘要

本研究旨在评估鲍曼不动杆菌临床分离株中抗生素耐药性的发生情况以及耐药决定因素的存在情况。这项横断面研究于2018年1月至9月对从伊朗北部临床样本中分离出的59株鲍曼不动杆菌菌株进行。通过标准微生物学检测和分子方法对分离株进行鉴定。采用纸片扩散法和肉汤微量稀释法进行药敏试验。通过PCR方法检测碳青霉烯耐药基因的存在情况。所有分离株对头孢吡肟、美罗培南、亚胺培南和头孢他啶均耐药。观察到对多西环素的耐药率最低,为33.9%。最低抑菌浓度(MIC)结果显示,所有耐碳青霉烯鲍曼不动杆菌(CRAB)分离株对黏菌素敏感,MIC50和MIC90值为1/2 µg/mL。在59株CRAB中,blaOXA-23-like是最常见的基因(86.4%),其次是blaOXA-24-like(69.5%)。同时,临床分离株中均未携带blaOXA-58-like基因。我们发现在伊朗北部携带OXA型碳青霉烯酶的CRAB菌株普遍存在。我们的结果表明,OXA型基因的存在与亚胺培南MIC水平的升高没有直接相关性,但因其有助于CRAB菌株的选择,在临床上可能具有重要意义。

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