Worku Minichil, Getie Michael, Moges Feleke, Mehari Alem Getaneh
University of Gondar Comprehensive Specialized Hospital Laboratory, Gondar, Ethiopia.
University of Gondar, College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, Department of Medical Microbiology, Gondar, Ethiopia.
Interdiscip Perspect Infect Dis. 2022 Mar 8;2022:7905350. doi: 10.1155/2022/7905350. eCollection 2022.
Resistance among the commensal flora is a serious threat because they are highly populated ecosystems like the gut, maybe a source of extraintestinal infections. Infections due to extended-spectrum beta-lactamase (ESBL)- and carbapenemase (CPM)-producing Enterobacteriaceae family of bacteria impose a major global issue because they are usually resistant to multiple antimicrobial agents. Data on the fecal ESBL- and CPM-producing group of bacteria in developing countries including Ethiopia are limited mainly due to resource constraints. Thus, this study aimed to determine the prevalence of multidrug-resistant (MDR)-, ESBL-, and CPM-producing Enterobacteriaceae family of bacteria from diarrheal stool samples at the University Hospital, Northwest Ethiopia.
A hospital-based cross-sectional study was conducted involving a total of 384 study participants having gastrointestinal complaints from January to April 2019. A diarrheal stool sample was aseptically collected and inoculated on a MacConkey agar plate. After getting pure colonies, biochemical and antimicrobial susceptibility testing was done following standard microbiological techniques. ESBL production was screened using ceftazidime and cefotaxime and confirmed using a combined disk diffusion test. Carbapenemases were screened by meropenem disk and confirmed by the modified carbapenem inactivation method. Data were checked, cleaned, and entered using Epi Info version 7.1 and transferred to SPSS version 20 for analysis.
A total of 404 Enterobacteriaceae groups of bacteria were isolated from 384 diarrheal stool samples. The overall prevalence of fecal MDR-, ESBL-, and CPM-producing group of Enterobacteriaceae was 196 (48.5%), 66 (16.3%), and 4 (1%), respectively. Of the total ESBL-producing Enterobacteriaceae, (41/66 (62.1%)) and (18/66 (27.3%)) were the most predominant isolates. One half of CPE has been observed in species and the rest in (25%) and (25%). . Finding the high rate of ESBL-producing Enterobacteriaceae and CPE requires strict infection control measures and careful selection of empirical therapy in the study area. Therefore, active surveillance with large sample size and better infection prevention control is needed.
共生菌群中的耐药性是一个严重威胁，因为它们是像肠道这样的高密集生态系统，可能是肠外感染的一个来源。由产超广谱β-内酰胺酶（ESBL）和碳青霉烯酶（CPM）的肠杆菌科细菌引起的感染是一个重大的全球问题，因为它们通常对多种抗菌药物耐药。在包括埃塞俄比亚在内的发展中国家，关于粪便中产ESBL和CPM的细菌的数据主要由于资源限制而有限。因此，本研究旨在确定埃塞俄比亚西北部大学医院腹泻粪便样本中产多重耐药（MDR）、ESBL和CPM的肠杆菌科细菌的患病率。
进行了一项基于医院的横断面研究，共纳入了2019年1月至4月有胃肠道不适的384名研究参与者。无菌采集腹泻粪便样本并接种在麦康凯琼脂平板上。获得纯菌落后，按照标准微生物技术进行生化和抗菌药物敏感性测试。使用头孢他啶和头孢噻肟筛选ESBL的产生，并通过联合纸片扩散试验进行确认。通过美罗培南纸片筛选碳青霉烯酶，并通过改良的碳青霉烯酶灭活方法进行确认。数据使用Epi Info 7.1版本进行检查、清理和录入，并转移到SPSS 20版本进行分析。
从384份腹泻粪便样本中总共分离出404株肠杆菌科细菌。粪便中产MDR、ESBL和CPM的肠杆菌科细菌的总体患病率分别为196株（48.5%）、66株（16.3%）和4株（1%）。在产ESBL的肠杆菌科细菌中， （41/66（62.1%））和 （18/66（27.3%））是最主要的分离株。在 菌种中观察到一半的产碳青霉烯酶肠杆菌，其余的在 和 中（各占25%）。 。在研究区域发现高产ESBL的肠杆菌科细菌和产碳青霉烯酶肠杆菌需要严格的感染控制措施和谨慎选择经验性治疗。因此，需要进行大样本量的主动监测和更好的感染预防控制。
