调查南非比勒陀利亚一家三级医院的多重耐药鲍曼不动杆菌分离株。
Investigating multi-drug resistant Acinetobacter baumannii isolates at a tertiary hospital in Pretoria, South Africa.
机构信息
Department of Microbiological Pathology, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
Department of Microbiological Pathology, Sefako Makgatho Health Sciences University, Pretoria, South Africa; National Health Laboratory Service, Dr George Mukhari Tertiary Laboratory, Pretoria, South Africa.
出版信息
Indian J Med Microbiol. 2021 Apr;39(2):218-223. doi: 10.1016/j.ijmmb.2021.03.005. Epub 2021 Apr 5.
PURPOSE
Antimicrobial resistance is now globally recognised amongst the greatest threat to human health. Acinetobacter baumannii's' (A. baumannii) clinical significance has been driven by its ability to obtain and transmit antimicrobial resistance factors. In South Africa, A. baumannii is a leading cause of healthcare associated infections (HAI). In this study, we investigated the genetic determinants of multi-drug resistant A. baumannii (MDRAB) at a teaching hospital in Pretoria, South Africa.
METHODS
One hundred non repetitive isolates of A. baumannii were collected for the study. Antimicrobial susceptibility testing was performed using the VITEK2 system. The prevalence of antibiotic resistance associated genes and AdeABC efflux pump system were investigated using conventional PCR. Genetic relatedness of isolates was determined using rep-PCR.
RESULTS
Seventy (70) of 100 isolates collected were confirmed multi-drug resistant and were blapositive. Phenotypically, the isolates where resistant to almost all tested antibiotics. One isolate showed intermediate susceptibility to tigecycline while all were susceptible to colistin. Oxacillinase gene bla was the most detected at 99% and only 1% was positive for bla. For Metallo-betalactamases (MBL), blawas the most frequently detected at 86% and bla at 3% was the least detected. Fifty-six isolates had the required gene combination for an active efflux pump. The most prevalent clone was clone A at 69% of the isolates. Colistin and tigecycline are the most effective against investigated isolates.
CONCLUSION
The major genotypic determinant for drug resistances is oxacillinases bla. The study reports for the first time, bla and bla detection in A. baumannii in South Africa.
目的
抗菌药物耐药性现在已被全球公认为对人类健康的最大威胁之一。鲍曼不动杆菌（A.baumannii）的临床意义归因于其获得和传播抗菌药物耐药性因素的能力。在南非，A.baumannii 是导致医疗保健相关感染（HAI）的主要原因。在这项研究中，我们研究了南非比勒陀利亚一家教学医院中多重耐药鲍曼不动杆菌（MDRAB）的遗传决定因素。
方法
本研究共收集了 100 株非重复鲍曼不动杆菌分离株。使用 VITEK2 系统进行抗菌药物敏感性测试。使用常规 PCR 研究抗生素耐药相关基因和 AdeABC 外排泵系统的流行情况。使用 rep-PCR 确定分离株的遗传相关性。
结果
在所收集的 100 株分离株中，有 70 株被确认为多重耐药且 bla 阳性。表型上，这些分离株对几乎所有测试的抗生素均具有耐药性。有 1 株对替加环素表现出中介敏感性，而所有分离株对黏菌素均敏感。 检测到的最多的是 99%的 bla 基因，而只有 1%的 bla 基因阳性。对于金属-β-内酰胺酶（MBL），检测到最频繁的是 86%的 blawas，而最少的是 3%的 bla。56 株分离株具有活性外排泵的必需基因组合。最常见的克隆是 69%的分离株属于克隆 A。多粘菌素和替加环素对所研究的分离株最有效。
结论
药物耐药的主要基因型决定因素是青霉素酶 bla。本研究首次在南非报告了 bla 和 bla 在鲍曼不动杆菌中的检测。
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