Abbasi Montazeri Effat, Khosravi Azar Dokht, Saki Morteza, Sirous Mehrandokht, Keikhaei Bijan, Seyed-Mohammadi Sakineh
Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Infect Drug Resist. 2020 May 6;13:1319-1326. doi: 10.2147/IDR.S254357. eCollection 2020.
This study aimed to evaluate the frequency rate of extended-spectrum beta-lactamase-producing (ESBL-PE) causing bloodstream infections (BSIs) in cancer patients referred to one of the major referral hospitals in Ahvaz city, southwest Iran.
In this study, 1700 blood cultures were collected from 610 cancer patients suspected to have BSI from October 2016 to August 2017 referred to the Shafa cancer hospital, Ahvaz, southwest of Iran. The blood culture bottles were incubated aerobically at 35-37ºC for 24 hours and then sub-cultured on routine microbiology culture media. The bacterial colonies were identified using standard tests. The antibiotic susceptibility testing was achieved by the disc-diffusion method. The phenotypic detection of ESBLs was carried out by the combination disc-diffusion test (CDDT). Finally, the polymerase chain reaction (PCR) was performed to investigate the presence of , , and genes.
The prevalence of BSI in cancer patients was 16.4% (100/610). Gram-negative rods with rate of 74% (74/100) were the most prevalent bacteria. The frequency of family was 21% including (n: 8), (n: 6), spp. (n: 5), (n: 1), and (n: 1). All isolates were multidrug-resistant (resistance to three or more antibiotics). The results of CDDT showed that 42.8% (9/21) of isolates had a positive ESBL test of which 100% (9/9) indicated positive band for at least one of the ESBL genes by PCR method. The and genes were detected in 38% (8/21) and 23.8% (5/21) of isolates, respectively, while the and were not detected in any isolates.
Based on the results, surveillance, and antibiotic stewardship programs should be implemented for cancer patients to prevent the spread of more ESBL-PE that have limited therapeutically choices.
本研究旨在评估在转诊至伊朗西南部阿瓦士市一家主要转诊医院的癌症患者中，产超广谱β-内酰胺酶（ESBL-PE）导致血流感染（BSI）的发生率。
在本研究中，2016年10月至2017年8月期间，从转诊至伊朗西南部阿瓦士市沙法癌症医院的610例疑似患有BSI的癌症患者中采集了1700份血培养样本。血培养瓶在35 - 37ºC有氧条件下孵育24小时，然后在常规微生物培养基上进行传代培养。使用标准试验鉴定细菌菌落。通过纸片扩散法进行抗生素敏感性试验。通过组合纸片扩散试验（CDDT）进行ESBLs的表型检测。最后，进行聚合酶链反应（PCR）以研究blaTEM、blaSHV、blaCTX-M和blaOXA基因的存在情况。
癌症患者中BSI的患病率为16.4%（100/610）。革兰氏阴性杆菌占比74%（74/100），是最常见的细菌。肠杆菌科的频率为21%，包括大肠埃希菌（n：8）、肺炎克雷伯菌（n：6）、阴沟肠杆菌属（n：5）、弗劳地枸橼酸杆菌（n：1）和产气肠杆菌（n：1）。所有分离株均对多种药物耐药（对三种或更多种抗生素耐药）。CDDT结果显示，42.8%（9/21）的肠杆菌科分离株ESBL试验呈阳性，其中100%（9/9）通过PCR方法显示至少一种ESBL基因呈阳性条带。分别在38%（8/21）和23.8%（5/21）的分离株中检测到blaCTX-M和blaSHV基因，而在任何分离株中均未检测到blaTEM和blaOXA基因。
基于这些结果，应为癌症患者实施监测和抗生素管理计划，以防止更多治疗选择有限的ESBL-PE传播。
