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加沙地带临床样本中分离出的菌株对黏菌素的耐药性

Colistin Resistance among Isolated from Clinical Samples in Gaza Strip.

作者信息

Qadi Mohammad, Alhato Safaa, Khayyat Rasha, Elmanama Abdelraouf A

机构信息

Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, P.O.Box. 7, Nablus, Palestine, State of Palestine.

Department of Medical Laboratory Sciences Faculty of Health Sciences Islamic University of Gaza, Gaza Strip, Gaza, Palestine, State of Palestine.

出版信息

Can J Infect Dis Med Microbiol. 2021 Apr 20;2021:6634684. doi: 10.1155/2021/6634684. eCollection 2021.

Abstract

Bacterial infections, especially drug-resistant infections, are a major global health issue. The emergence of multidrug-resistant (MDR) strains of and the lack of new antibiotics have worrisome prospects for all of humanity. Colistin is considered the last-line drug for MDR Gram-negative bacteria (GNB), and it is often used for treatment of respiratory infections caused by MDR-GNB. In recent years, there has been a marked increase in the incidence of colistin-resistant infections. The main objective of this study was to investigate the presence of colistin resistance among clinical GNB isolated from Gaza Strip hospitals. Clinical isolates (100) were obtained from microbiology laboratories of the hospitals of different geographical locations in Gaza Strip Governorate over a period of six months. Samples were cultured, and bacterial identification was performed by standard microbiological procedures. isolates were tested for their antimicrobial susceptibility by the disk diffusion method and the MIC method for colistin. Varying degrees of susceptibility were observed for the isolates against the tested antimicrobials even within members of the same antimicrobial class. Amikacin was the most effective drug (74%), followed by chloramphenicol (48%), fosfomycin, and gentamicin (45%). High resistance was recorded against trimethoprim (85%) and tetracycline (83%). Only 59% of the tested isolates were interpreted as susceptible, while 41% was classified as resistant. The highest resistance to colistin was found to be among the spp. (63.2%), followed by spp. (57.1%). The lowest resistance was observed among isolates (31.6%). Only 39.0% of meropenem-resistant was susceptible to colistin, while 45.8% of imipenem-resistant was susceptible to colistin. The overall resistance to colistin was high (41%) among tested clinical isolates. Furthermore, 89% was MDR. These limit and complicate treatment options for the infections caused by in Gaza Strip. This calls for immediate actions to control and monitor the use of antimicrobials in general and colistin in particular.

摘要

细菌感染,尤其是耐药性感染,是一个重大的全球健康问题。多重耐药(MDR)菌株的出现以及新抗生素的匮乏,给全人类带来了令人担忧的前景。黏菌素被认为是治疗MDR革兰氏阴性菌(GNB)的最后一线药物,常用于治疗由MDR - GNB引起的呼吸道感染。近年来,耐黏菌素感染的发生率显著上升。本研究的主要目的是调查从加沙地带医院分离出的临床GNB中耐黏菌素情况。在六个月的时间里,从加沙地带不同地理位置医院的微生物实验室获取了100株临床分离株。对样本进行培养,并通过标准微生物学程序进行细菌鉴定。采用纸片扩散法和黏菌素的MIC法对分离株进行抗菌药敏试验。即使在同一抗菌药物类别成员中,分离株对受试抗菌药物也表现出不同程度的敏感性。阿米卡星是最有效的药物(74%),其次是氯霉素(48%)、磷霉素和庆大霉素(45%)。对甲氧苄啶(85%)和四环素(83%)的耐药率较高。仅59%的受试分离株被判定为敏感,而41%被归类为耐药。发现对黏菌素耐药率最高的是某菌属(63.2%),其次是另一菌属(57.1%)。在另一分离株中观察到的耐药率最低(31.6%)。仅39.0%的耐美罗培南某菌对黏菌素敏感,而45.8%的耐亚胺培南某菌对黏菌素敏感。受试临床分离株中对黏菌素的总体耐药率较高(41%)。此外,89%为多重耐药。这些限制了加沙地带由某菌引起的感染的治疗选择并使其复杂化。这就要求立即采取行动,总体上控制和监测抗菌药物的使用,尤其是黏菌素的使用。

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