替加环素对多重耐药革兰氏阴性菌的体外活性：一家大学医院的经验。
In-vitro activity of tigecycline against multidrug-resistant Gram negative bacteria: The experience of a university hospital.
机构信息
Pathology and Microbiology Department, Jordan University of Science and Technology, Jordan.
Medical Laboratory Sciences Department, Jordan University of Science and Technology, Jordan.
出版信息
J Infect Public Health. 2021 Apr;14(4):478-483. doi: 10.1016/j.jiph.2020.12.013. Epub 2021 Mar 17.
The emergence of multidrug-resistant Gram negative bacteria has given rise to significant therapeutic challenges. These pathogens may have developed resistance to tigecycline, which is an alternative antibiotic used empirically in the treatment of serious infections. The objectives of this study were to identify the in-vitro activity of tigecycline against multidrug-resistant Gram negative strains isolated from clinical specimens and their related genes, at a university hospital. For this, 150 clinical isolates of multidrug-resistant Gram negative cultures from various clinical specimens were collected. Bacterial isolates were cultured, identified and their antibiotic susceptibilities were determined. Polymerase chain reaction was performed to amplify AcrB, AmpC, RamR, MexR, AdeB, TetA genes. Results revealed that all isolates were multidrug-resistant. The resistance of isolates was 91.4% to aztreonam, 94.6% to piperacillin, 34% to imipenem, 38.7% to meropenem, 71.3% to levofloxacin, 97.3% to ceftriaxone, 94.7% to cefepime, 9.3% to colistin, 78% to tetracycline, 21.4% to tigecycline and 68% to trimethoprim. AcrB, AmpC, RamR, MexR, AdeB, TetA genes were present in multidrug-resistant Gram negative bacteria. AcrB, RamR, TetA genes were related to tigecycline resistance. It is concluded that infections caused by multidrug-resistant Gram negative bacteria occur at a high rate. Most isolates were multi drug resistant, with 21.4% being resistant to tigecycline.
革兰氏阴性多重耐药菌的出现带来了重大的治疗挑战。这些病原体可能对替加环素产生了耐药性，替加环素是一种经验性用于治疗严重感染的替代抗生素。本研究的目的是在一所大学医院鉴定分离自临床标本的革兰氏阴性多重耐药菌株的替加环素的体外活性及其相关基因。为此，收集了来自各种临床标本的 150 株革兰氏阴性多重耐药培养物的临床分离株。培养细菌分离株并鉴定其抗生素敏感性。进行聚合酶链反应以扩增 AcrB、AmpC、RamR、MexR、AdeB、TetA 基因。结果显示，所有分离株均为多重耐药菌。分离株对氨曲南的耐药率为 91.4%，对哌拉西林的耐药率为 94.6%，对亚胺培南的耐药率为 34%，对美罗培南的耐药率为 38.7%，对左氧氟沙星的耐药率为 71.3%，对头孢曲松的耐药率为 97.3%，对头孢吡肟的耐药率为 94.7%，对黏菌素的耐药率为 9.3%，对四环素的耐药率为 78%，对替加环素的耐药率为 21.4%，对甲氧苄啶的耐药率为 68%。AcrB、AmpC、RamR、MexR、AdeB、TetA 基因存在于革兰氏阴性多重耐药菌中。AcrB、RamR、TetA 基因与替加环素耐药有关。结论是，由革兰氏阴性多重耐药菌引起的感染发生率很高。大多数分离株为多药耐药株，其中 21.4%对替加环素耐药。
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