Tiongco R E, Arceo E, Dizon D, Navarro A, Rivera N, Salita C, Singian E
Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, Philippines.
Trop Biomed. 2018 Dec 1;35(4):1064-1074.
Antimicrobial resistance is a worldwide public health concern. Rise in the number of antimicrobial resistant organisms, such as extended spectrum β-lactamase- (ESBL) and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae, continue to burden millions of people worldwide. E. coli and K. pneumoniae were isolated and collected for four months from a teaching hospital in the Philippines. All isolates were subjected to ESBL and carbapenemase testing using the double disk synergy test and modified Hodge test, respectively. Their pattern of resistance among different classes of antimicrobial agents was also investigated using the Kirby-Bauer disk diffusion test. Among the 32 clinical isolates tested, 28.1% were positive for ESBL production and 6.3% were positive for carbapenemase production. Species-specific classification showed that E. coli (44.4%) has the highest rate of ESBL production whereas both E. coli (5.6%) and K. pneumoniae (7.1%) showed almost similar rates of carbapenemase production. Antimicrobial resistance pattern of drug resistant isolates showed that all organisms were resistant to ampicillin, and majority showed resistance towards ciprofloxacin, cefotaxime, ceftriaxone, and sulfamethoxazole/trimethoprim. ESBL production is seen highest among E. coli isolates while similar rates of carbapenemase production was observed to both E. coli and K. pneumoniae isolates. Overall, antimicrobial resistance continues to rise and poses a huge threat in public health worldwide. Efforts should be made in developing rapid tests for antimicrobial resistance and to search for effective treatment from infections caused by multidrug resistant organisms.
抗菌药物耐药性是一个全球性的公共卫生问题。抗菌耐药菌数量的增加，如产超广谱β-内酰胺酶（ESBL）和碳青霉烯酶的大肠埃希菌和肺炎克雷伯菌，继续给全球数百万人带来负担。从菲律宾的一家教学医院分离并收集大肠埃希菌和肺炎克雷伯菌达四个月之久。所有分离株分别使用双纸片协同试验和改良 Hodge 试验进行 ESBL 和碳青霉烯酶检测。还使用 Kirby-Bauer 纸片扩散试验研究了它们对不同类抗菌药物的耐药模式。在所检测的 32 株临床分离株中，28.1%的菌株产 ESBL 呈阳性，6.3%的菌株产碳青霉烯酶呈阳性。种属特异性分类显示，大肠埃希菌产 ESBL 的比例最高（44.4%），而大肠埃希菌（5.6%）和肺炎克雷伯菌（7.1%）产碳青霉烯酶的比例几乎相似。耐药分离株的抗菌药物耐药模式表明，所有菌株均对氨苄西林耐药，大多数菌株对环丙沙星、头孢噻肟、头孢曲松和磺胺甲恶唑/甲氧苄啶耐药。大肠埃希菌分离株中产 ESBL 的情况最为常见，而大肠埃希菌和肺炎克雷伯菌分离株中产碳青霉烯酶的比例相似。总体而言，抗菌药物耐药性持续上升，对全球公共卫生构成巨大威胁。应努力开发快速的抗菌药物耐药性检测方法，并寻找针对多重耐药菌引起感染的有效治疗方法。
