Infectious Diseases Laboratory, Institute for Developing Science and Health Initiatives, Dhaka, Bangladesh.
Department of Mathematics and Natural Sciences, BRAC University, Dhaka, Bangladesh.
Trop Med Int Health. 2021 Jul;26(7):720-729. doi: 10.1111/tmi.13584. Epub 2021 May 2.
Characterisation of resistance phenotype and genotype is crucial to understanding the burden and transmission of antimicrobial resistance (AMR). This study aims to determine the spectrum of AMR and associated genes encoding aminoglycoside, macrolide and β-lactam classes of antimicrobials in bacteria isolated from hospitalised patients in Bangladesh.
430 bacterial isolates from patients with respiratory, intestinal, wound infections and typhoid fever, presenting to clinical care from 2015 to 2019, were examined. They included Escherichia coli (n = 85); Staphylococcus aureus (n = 84); Salmonella typhi (n = 82); Klebsiella pneumoniae (n = 42); Streptococcus pneumoniae (n = 36); coagulase-negative staphylococci (n = 28); Enterococcus faecalis (n = 27); Pseudomonas aeruginosa (n = 26); and Acinetobacter baumannii (n = 20). Reconfirmation of these clinical isolates and antimicrobial susceptibility tests was performed. PCR amplification using resistance gene-specific primers was done, and the amplified products were confirmed by Sanger sequencing.
53% of isolates were multidrug-resistant (MDR), including 97% of Escherichia coli. There was a year-wise gradual increase in MDR isolates from 2015 to 2018, and there was an almost twofold increase in the number of MDR strains isolated in 2019 (P = 0.00058). Among the 5 extended-spectrum β-lactamases investigated, CTX-M-1 was the most prevalent (63%) followed by NDM-1 (22%); Escherichia coli was the major reservoir of these genes. The ermB (55%) and aac(6')-Ib (35%) genes were the most frequently detected macrolide and aminoglycoside resistance genes, respectively.
MDR pathogens are highly prevalent in hospital settings of Bangladesh.
耐药表型和基因型的特征对于了解抗菌药物耐药性（AMR）的负担和传播至关重要。本研究旨在确定孟加拉国住院患者分离的细菌中氨基糖苷类、大环内酯类和β-内酰胺类抗菌药物的 AMR 谱及其相关基因。
从 2015 年至 2019 年期间因呼吸道、肠道、伤口感染和伤寒而就诊于临床护理的患者中，共检查了 430 株细菌分离株。其中包括大肠杆菌（n=85）；金黄色葡萄球菌（n=84）；伤寒沙门氏菌（n=82）；肺炎克雷伯菌（n=42）；肺炎链球菌（n=36）；凝固酶阴性葡萄球菌（n=28）；粪肠球菌（n=27）；铜绿假单胞菌（n=26）；鲍曼不动杆菌（n=20）。对这些临床分离株进行了重新确认和抗菌药物敏感性测试。使用耐药基因特异性引物进行 PCR 扩增，并通过 Sanger 测序确认扩增产物。
53%的分离株为多重耐药（MDR），其中 97%为大肠杆菌。2015 年至 2018 年，MDR 分离株呈逐年增加趋势，2019 年 MDR 菌株数量增加近两倍（P=0.00058）。在所研究的 5 种扩展型β-内酰胺酶中，CTX-M-1（63%）最为常见，其次是 NDM-1（22%）；大肠杆菌是这些基因的主要储库。ermB（55%）和 aac(6')-Ib（35%）基因是最常见的大环内酯类和氨基糖苷类耐药基因。
MDR 病原体在孟加拉国医院环境中高度流行。
