Irfan Sofia, Azhar Aysha, Bashir Asad, Ahmed Salman, Haque Abdul
Sofia Irfan, B.Sc. (Hons.). Department of Health Biotechnology, Akhuwat FIRST, Faisalabad, Pakistan.
Aysha Azhar, PhD. Postgraduate Research Laboratory, The University of Faisalabad, Faisalabad, Pakistan.
Pak J Med Sci. 2021 Jan-Feb;37(1):34-39. doi: 10.12669/pjms.37.1.3192.
The objective of the current study was to find prevalence of relevant ESBL and carbapenemase producing genes in nosocomial and isolates and to check phenotypic susceptibility of all ESBL positive isolates to carbapenems.
Forty ESBL producing clinical isolates of (n=33) and (n=7) were examined for the presence of β-lactamase genes (CTX-M, CTX-M-1, 2, 3, 4 and TEM). Carbapenem resistance was checked phenotypically and by presence of gene.
Nine (27%) were positive for CTX-M genes, and 10 (30%) for TEM among isolates. Importantly, six isolates showed co-existence of CTX-M and TEM genes. In , two (28%) isolates were positive for CTX-M and one (14%) for TEM genes. Eight (24%) and one (14%) isolates were positive for CTX-M-1. Respective figures for CTX-M-4 were three (10%) and one (14%). CTX-M-2 and CTX-M-3 groups were not represented. Twenty (50%) isolates were resistant to both imipenem and meropenem out of which only four isolates expressed gene.
The significant presence of both ESBL and carbapenemase producers and co-existence of ESBL and carbapenemases in the same isolates is worrisome.
本研究的目的是确定医院分离株中产生超广谱β-内酰胺酶（ESBL）和碳青霉烯酶的相关基因的流行情况，并检测所有ESBL阳性分离株对碳青霉烯类药物的表型敏感性。
对40株产ESBL的临床分离株（肺炎克雷伯菌33株，大肠埃希菌7株）检测β-内酰胺酶基因（CTX-M、CTX-M-1、2、3、4和TEM）的存在情况。通过表型检测及基因检测来检查碳青霉烯类耐药情况。
在肺炎克雷伯菌分离株中，9株（27%）CTX-M基因阳性，10株（30%）TEM基因阳性。重要的是，6株分离株显示CTX-M和TEM基因共存。在大肠埃希菌中，2株（28%）CTX-M基因阳性，1株（14%）TEM基因阳性。8株肺炎克雷伯菌（24%）和1株大肠埃希菌（14%）CTX-M-1基因阳性。CTX-M-4的相应比例分别为3株（10%）和1株（14%）。未发现CTX-M-2和CTX-M-3组。20株（50%）分离株对亚胺培南和美罗培南均耐药，其中只有4株表达碳青霉烯酶基因。
ESBL和碳青霉烯酶产生菌的大量存在以及同一分离株中ESBL和碳青霉烯酶的共存令人担忧。
