Al-Khudhairy M K, Al-Shammari M M M
Department of Community Health, College of Health and Medical Techniques, Al-Furat Al-Awsat Technical University, Kufa, Iraq.
College of Medicine, Jabir Ibn Hayyan Medical University, Al-Najaf, Iraq.
New Microbes New Infect. 2020 Feb 16;35:100661. doi: 10.1016/j.nmni.2020.100661. eCollection 2020 May.
Metallo-β-lactamase (MBL)-producing is a major cause of nosocomial infections. However, there is little information in Iraq regarding its prevalence in patients with diabetic foot ulcer. Carbapenems are efficient antibiotics against extended-spectrum β-lactamase-producing . However, there are many potential health risks associated with carbapenem-resistant . We aimed to determine MBL-producing isolated from diabetic foot ulcer infections. A total of 97 isolates were isolated from pus and deep tissue swabs of 282 patients admitted to Al-Sader hospital, Najaf City, Iraq, with diabetic foot infections from October 2017 to January 2018. All isolates were tested by the Kirby-Bauer disc diffusion method for evaluating 13 antibiotics. Phenotypic carbapenem resistance was confirmed by the combined disc test, double-disc synergy test, modified Hodge test and CHROMagar KPC agar. All phenotypic MBL-producing isolates were screened for , , , and genes by multiplex PCR. Of the 97 isolates, combined disc test and modified Hodge test revealed 12 isolates (12.4%) to be MBL producers, and ten (10.3%) displayed MBL production as accessed by CHROMagar KPC agar test. Nine isolates (9.3%) were carbapenemase producers by the imipenem and ceftizoxime double-disc synergy test. Of 12 phenotypic MBL-producing , PCR amplification confirmed 4 (33.3%) and 3 (25%) isolates harbouring and gene respectively, but none carried the , or genes. The steady and rapid increase of MBL production is worrisome and needs to be controlled through extensive studies and more judicious selection of antibiotics, especially carbapenems.
产金属β-内酰胺酶（MBL）是医院感染的主要原因。然而，伊拉克关于糖尿病足溃疡患者中产MBL情况的信息很少。碳青霉烯类是对抗产超广谱β-内酰胺酶菌的有效抗生素。然而，耐碳青霉烯菌存在许多潜在健康风险。我们旨在确定从糖尿病足溃疡感染中分离出的产MBL菌。2017年10月至2018年1月，从伊拉克纳杰夫市萨德尔医院收治的282例患有糖尿病足感染的患者的脓液和深部组织拭子中，共分离出97株菌。所有分离菌均采用 Kirby-Bauer 纸片扩散法检测13种抗生素。通过联合纸片试验、双纸片协同试验、改良 Hodge 试验和CHROMagar KPC琼脂确认表型碳青霉烯耐药。通过多重PCR对所有表型产MBL的分离菌进行、、、和基因筛查。在97株分离菌中，联合纸片试验和改良 Hodge 试验显示12株（12.4%）为产MBL菌，通过CHROMagar KPC琼脂试验检测发现10株（10.3%）产MBL。通过亚胺培南和头孢唑肟双纸片协同试验，9株（9.3%）为碳青霉烯酶产生菌。在12株表型产MBL菌中，PCR扩增分别确认4株（33.3%）和3株（25%）分离菌携带和基因，但均未携带、或基因。MBL产生菌的稳定且快速增加令人担忧，需要通过广泛研究和更合理地选择抗生素，尤其是碳青霉烯类来加以控制。
