Vega Silvio, Acosta Fermín, Landires Iván, Morán Mitchelle, Gonzalez Johanna, Pimentel-Peralta Gumercindo, Núñez-Samudio Virginia, Goodridge Amador
Laboratorio Clínico, Complejo Hospitalario Metropolitano Dr. Arnulfo Arias Madrid, Caja de Seguro Social (CHMDrAAM-CSS), Panama City, Panama.
Tuberculosis Biomarker Research Unit at Centro de Biología Molecular y Celular de Enfermedades (CBCME) del Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), City of Knowledge, Panama.
Ther Adv Infect Dis. 2021 Oct 30;8:20499361211054918. doi: 10.1177/20499361211054918. eCollection 2021 Jan-Dec.
is a versatile bacterial species able to acquire antimicrobial resistance; the species presents a higher antimicrobial resistance profile compared to Carbapenemase and extended spectrum β-lactamase (ESBL)-producing bacteria commonly arise in clinical settings where antimicrobial stewardship is limited. Our study aims to report the phenotypical and genetic characteristics of nosocomial isolates associated with mortality collected from a tertiary-level hospital in Panama City. In October 2020, 11 consecutive multidrug-resistant Gram-negative isolates were recovered from secretions and blood cultures from hospitalized patients. Nearly 90% (10/11) of these patients died, and bacteria was obtained from six patients for investigation. Biochemical evaluation of the six isolates revealed the presence of multidrug-resistant Phenotypic evaluation indicated resistance to carbapenemase and EBSL. In contrast, genetic evaluation by PCR showed that only 30% (2/6) were resistant to CTX-M-1 (CTX-M group 1), whereas 60.7% (4/6) presented carbapenemase resistance genes, and 33.3% (2/6) presented New Delhi metallo-β-lactamase () resistance genes. ST258 was identified in 83.3% (5/6) of the isolates. Phylogenetic analysis using 16S revealed low homology among the six isolates. These results suggest that antibiotic resistance genes may have been incorporated into these isolates within the hospital environment. We recommend strengthening the antimicrobial stewardship program and antibiotic control policy, as well as heightened infection control and prevention measures, such as ward sanitation and increased hand washing frequency.
是一种能够获得抗菌耐药性的多能细菌物种;与碳青霉烯酶和产超广谱β-内酰胺酶(ESBL)的细菌相比,该物种呈现出更高的抗菌耐药性特征,这些细菌通常出现在抗菌管理有限的临床环境中。我们的研究旨在报告从巴拿马城一家三级医院收集的与死亡相关的医院分离株的表型和基因特征。2020年10月,从住院患者的分泌物和血培养物中连续分离出11株多重耐药革兰氏阴性菌。这些患者中近90%(10/11)死亡,从6名患者身上获取细菌进行调查。对这6株分离株的生化评估显示存在多重耐药性。表型评估表明对碳青霉烯酶和ESBL耐药。相比之下,通过PCR进行的基因评估显示,只有30%(2/6)对CTX-M-1(CTX-M组1)耐药,而60.7%(4/6)呈现碳青霉烯酶耐药基因,33.3%(2/6)呈现新德里金属β-内酰胺酶()耐药基因。83.3%(5/6)的分离株中鉴定出ST258。使用16S进行的系统发育分析显示这6株分离株之间同源性较低。这些结果表明抗生素耐药基因可能已在医院环境中整合到这些分离株中。我们建议加强抗菌管理计划和抗生素控制政策,以及加强感染控制和预防措施,如病房卫生和增加洗手频率。