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从埃塞俄比亚北贡德尔健康中心就诊患者中分离出的耐亚胺培南革兰氏阴性菌水平升高。

Elevated Level of Imipenem-Resistant Gram-Negative Bacteria Isolated from Patients Attending Health Centers in North Gondar, Ethiopia.

作者信息

Abda Ebrahim M, Adugna Zenebe, Assefa Adugna

机构信息

Department of Biotechnology, College of Biological and Chemical Engineering, Addis Ababa Science and Technology University, Addis Ababa, Ethiopia.

Department of Biology, College of Natural and Computational Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Infect Drug Resist. 2020 Dec 17;13:4509-4517. doi: 10.2147/IDR.S287700. eCollection 2020.

Abstract

BACKGROUND

The frequent identification of resistant bacteria in hospitals constantly presents antimicrobial therapy with a challenge. Imipenem, once considered an extremely powerful antibiotic against multidrug-resistant bacterial infections, is losing its effectiveness. Its use in empirical therapy with inadequate or nonexistent antimicrobial stewardship programs has further triggered bacterial resistance in low-income countries. Therefore, this study aimed at identifying imipenem-resistant Gram-negative bacteria from patients who were referred to health centers in North Gondar, Ethiopia.

METHODS

A total of 153 sputum samples were used to isolate Gram-negative bacteria. The isolates, which were resistant to imipenem, were identified by standard biochemical tests and 16S rRNA sequencing. The Kirby-Bauer disk diffusion method was used to determine the sensitivity or resistance of the isolate to diverse antimicrobial agents.

RESULTS

The study identified 79 imipenem-resistant bacterial isolates from eight genera with clinically relevant microorganisms, including (20.77%), (19.48%), (16.88%), and (14.28%). Overall, imipenem-resistant bacterial isolates were detected in 31 samples (20.26%). Additionally, a remarkably high level of resistance to most antibiotics was observed among isolates of . Gentamycin is the most active antibiotic against many of the isolates, while β-lactams appear to be less effective.

CONCLUSION

The study indicated that many Gram-negative bacteria were resistant to imipenem with parallel resistances to other antimicrobials. Hence, the prescription of imipenem within the region should be according to the antibiotic resistance profiles of the multi-drug resistant bacteria.

摘要

背景

医院中耐药菌的频繁发现不断给抗菌治疗带来挑战。亚胺培南曾被认为是对抗多重耐药细菌感染的极其强大的抗生素,但其有效性正在丧失。在低收入国家,在抗菌管理计划不完善或不存在的情况下将其用于经验性治疗,进一步引发了细菌耐药性。因此,本研究旨在从转诊至埃塞俄比亚北贡德尔卫生中心的患者中鉴定出对亚胺培南耐药的革兰氏阴性菌。

方法

共使用153份痰标本分离革兰氏阴性菌。通过标准生化试验和16S rRNA测序鉴定对亚胺培南耐药的分离株。采用 Kirby-Bauer 纸片扩散法测定分离株对多种抗菌药物的敏感性或耐药性。

结果

该研究从包括(20.77%)、(19.48%)、(16.88%)和(14.28%)在内的八个属的具有临床相关性的微生物中鉴定出79株对亚胺培南耐药的细菌分离株。总体而言,在31份样本(20.26%)中检测到了对亚胺培南耐药的细菌分离株。此外,在的分离株中观察到对大多数抗生素的耐药水平显著较高。庆大霉素是对许多分离株最有效的抗生素,而β-内酰胺类抗生素似乎效果较差。

结论

该研究表明,许多革兰氏阴性菌对亚胺培南耐药,同时对其他抗菌药物也有耐药性。因此,该地区亚胺培南的处方应根据多重耐药细菌的抗生素耐药谱来确定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aebe/7751593/269ce92bb6af/IDR-13-4509-g0001.jpg

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