Mohamed Amira, Daef Enas, Nafie Amany, Shaban Lamia, Ibrahim Maggie
Clinical Pharmacy, Women's Health Hospital, Assiut University, Assiut 71711, Egypt.
Microbiology and Immunology Department, Faculty of Medicine, Assiut University, Assiut 71711, Egypt.
Antibiotics (Basel). 2021 Oct 29;10(11):1325. doi: 10.3390/antibiotics10111325.
Carbapenem-resistant Gram-negative bacilli (CR-GNB) has become a global threat. In hospital settings, the association of CR-GNB with ventilator-associated pneumonia (VAP) is a critical public health concern owing to their high resistance rate to most antibiotics. The present study aims to identify the frequency of carbapenem-resistance and to determine the rate of multidrug resistance (MDR), extensive drug resistance (XDR) and pan-drug resistance (PDR) among CR-GNB infections in VAP. Antimicrobial susceptibility testing was carried out using the disk diffusion method and the detection of carbapenemases was screened using the imipenem-E test and the modified carbapenem-inactivation method (mCIM). The isolates were verified by polymerase chain reaction (PCR) for the presence of , , , and genes. 89.5%, 14%, 17.5%, 10.5%, 3.5% of isolates exhibited the presence of , , , and , respectively. 76%, 17% and 7% of isolates were PDR, XDR, and MDR, respectively. Carbapenem-resistance genes were identified in a significant percentage and was the most predominant gene. All isolates were highly resistant to most antibiotics. This health concern has proven to be a big challenge in developing countries such as Egypt, as it is associated with high morbidity, high mortality, and raised healthcare costs.
耐碳青霉烯类革兰氏阴性杆菌(CR-GNB)已成为全球威胁。在医院环境中,CR-GNB与呼吸机相关性肺炎(VAP)的关联是一个关键的公共卫生问题,因为它们对大多数抗生素的耐药率很高。本研究旨在确定碳青霉烯耐药的频率,并确定VAP中CR-GNB感染的多重耐药(MDR)、广泛耐药(XDR)和泛耐药(PDR)率。采用纸片扩散法进行药敏试验,并使用亚胺培南-E试验和改良碳青霉烯灭活方法(mCIM)筛选碳青霉烯酶。通过聚合酶链反应(PCR)验证分离株中是否存在 、 、 、 和 基因。分别有89.5%、14%、17.5%、10.5%、3.5%的分离株表现出 、 、 、 和 的存在。分别有76%、17%和7%的分离株为PDR、XDR和MDR。在相当比例的菌株中鉴定出碳青霉烯耐药基因,且 是最主要的基因。所有分离株对大多数抗生素都具有高度耐药性。在埃及等发展中国家,这种健康问题已被证明是一个巨大挑战,因为它与高发病率、高死亡率和医疗成本增加有关。