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检测特美汀-1 和 1 类整合子在尼日利亚西南部一家三级保健医院无症状菌尿的 HIV 患者的多重耐药尿路病原体中的存在情况。

Detection of tem-1 and class-1 integrons in multidrug resistant uropathogens from HIV patients with asymptomatic bacteriuria in a Tertiary Care Hospital, SouthWest Nigeria.

机构信息

Department of Medical Microbiology and Parasitology, Obafemi Awolowo University, Ile-Ife, Nigeria.

Department of Haematology and Immunology, Obafemi Awolowo University, Ile-Ife, Nigeria.

出版信息

Afr Health Sci. 2022 Mar;22(1):475-485. doi: 10.4314/ahs.v22i1.56.

Abstract

BACKGROUND

Human immunodeficiency virus (HIV) infected individuals are at increased risk of asymptomatic bacteriuria (ASB) due to immune suppression. The increasing resistance of uropathogens necessitates the need for regular monitoring of their profile to reduce drug resistance.

OBJECTIVES

We determined the prevalence of ASB and the characteristics of antibiotic-resistant uropathogens isolated from HIV patients.

METHODS

Mid-stream urine samples from 100 HIV positive and 100 HIV negative healthy individuals were cultured for significant bacteriuria. The isolates were identified by standard techniques and their susceptibility patterns determined by the Kirby-Bauer disc diffusion technique. All the Gram-negative isolates were screened for ESBL production by combined disc method, ESBL genes and class 1 integrons by Polymerase chain reaction.

RESULTS

Nine (9%) HIV positive individuals and 4 (4%) healthy individuals had ASB yielding a total of 13 (6.5%) uropathogens dominated by (53.9%). All isolates were multidrug resistant. Five isolates harboured both the blaTEM-1 gene and class 1integrons while produced ampC.

CONCLUSION

There is a higher burden of ASB characterized by multi-drug resistant uropathogens among HIV patients. Thus emphasizing the need for continuous resistance surveillance and antibiotic stewardship in our environment to reduce drug resistance and prevent treatment failure.

摘要

背景

由于免疫抑制,人类免疫缺陷病毒(HIV)感染者发生无症状菌尿(ASB)的风险增加。尿路病原体的耐药性不断增加,因此需要定期监测其耐药谱,以降低耐药性。

目的

我们旨在确定 HIV 患者中无症状菌尿的患病率以及分离出的耐药尿路病原体的特征。

方法

对 100 例 HIV 阳性和 100 例 HIV 阴性健康个体的中段尿样进行培养以检测有意义的菌尿。采用标准技术对分离株进行鉴定,并采用 Kirby-Bauer 纸片扩散法测定其药敏模式。采用联合纸片法筛选所有革兰氏阴性分离株是否产超广谱β-内酰胺酶(ESBL),采用聚合酶链反应(PCR)检测 ESBL 基因和 class 1 整合子。

结果

9 例(9%)HIV 阳性个体和 4 例(4%)健康个体出现 ASB,共分离出 13 株(6.5%)尿路病原体,以 (53.9%)为主。所有分离株均为多重耐药菌。5 株分离株同时携带 blaTEM-1 基因和 class 1 整合子, 株产 AmpC。

结论

HIV 患者中存在更高的无症状菌尿负担,其特征为多药耐药尿路病原体。因此,需要在我们的环境中持续进行耐药监测和抗生素管理,以降低耐药性并预防治疗失败。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2cd/9382535/d7e5f047c03a/AFHS2201-0475Fig1.jpg

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