Dr Jobyda Khanam, Lecturer, Department of Microbiology, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
Mymensingh Med J. 2021 Apr;30(2):329-336.
The occurrence of antimicrobial resistance in Salmonella enterica serovars (both typhoidal and non-typhoidal Salmonellae) is a major public health problem especially in developing countries, which have been associated with treatment failures. Therefore, the study was undertaken to determine the current antimicrobial resistance pattern and extended spectrum β-lactamase (ESBL) production among clinical isolates of Salmonella spp. during 2019-2020 in Mymensingh, Bangladesh. In this cross sectional study, 36 Salmonella enterica isolates were obtained from blood and stool culture of suspected 200 enteric fever and 100 gastroenteritis patients attending at Mymensingh Medical College Hospital, Mymensingh, Bangladesh. Isolated Salmonella species were identified by biochemical tests and Polymerase Chain Reaction (PCR). Disk diffusion test was performed by modified Kirby Bauer method. Minimum Inhibitory Concentration (MIC) of ceftriaxone was detected by agar dilution method. Double disk synergy test was used as a screening test for ESBL production. PCR was done for detection of blaTEM, blaSHV and blaCTX-MU genes. The isolates showed 25% resistance to Ceftriaxone and 58.3% to Azithromycin. The highest sensitivity rates were 88.9% to Meropenem and 83.3% to Amikacin. Whereas 6(16.7%) isolates were Multi Drug Resistant (MDR). Eight (8) isolates were confirmed as ESBL producer by DDST. The marked increase in MIC was observed between 8->512μg/ml to ceftriaxone. blaTEM, blaSHV and blaCTX-MU genes were detected in 3, 5 and 8 isolates respectively. In conclusion, the current study observed, higher level of resistance to ceftriaxone and azithromycin. At the same times 22.2% isolates showed ESBL production, which is a cause for concern as it may lead to treatment failure. On the other hand the study also showed the re-emergence of chloramphenicol and Sulfamethoxazole-Trimethoprim sensitivity.
沙门氏菌血清型（包括伤寒和非伤寒沙门氏菌）中抗菌药物耐药性的出现是一个主要的公共卫生问题，特别是在发展中国家，这与治疗失败有关。因此，本研究旨在确定 2019 年至 2020 年期间孟加拉国迈门辛市沙门氏菌属临床分离株的当前抗菌药物耐药模式和扩展谱β-内酰胺酶（ESBL）产生情况。在这项横断面研究中，从孟加拉国迈门辛市迈门辛格医学院医院就诊的 200 例肠热病和 100 例胃肠炎疑似患者的血液和粪便培养中获得了 36 株沙门氏菌肠杆菌。通过生化试验和聚合酶链反应（PCR）鉴定分离出的沙门氏菌。采用改良 Kirby Bauer 法进行纸片扩散试验。采用琼脂稀释法检测头孢曲松的最小抑菌浓度（MIC）。双纸片协同试验用于 ESBL 产生的筛选试验。通过 PCR 检测 blaTEM、blaSHV 和 blaCTX-MU 基因。分离株对头孢曲松的耐药率为 25%，对阿奇霉素的耐药率为 58.3%。对美罗培南和阿米卡星的敏感性最高，分别为 88.9%和 83.3%。而 6（16.7%）株为多药耐药（MDR）。8（8）株通过 DDST 确认为 ESBL 产生菌。头孢曲松的 MIC 明显增加，从 8->512μg/ml。在 3、5 和 8 株分离株中分别检测到 blaTEM、blaSHV 和 blaCTX-MU 基因。总之，本研究观察到头孢曲松和阿奇霉素的耐药水平较高。同时，22.2%的分离株表现出 ESBL 产生，这令人担忧，因为这可能导致治疗失败。另一方面，研究还表明氯霉素和磺胺甲恶唑-甲氧苄啶的敏感性重新出现。
