Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia.
Grupo de Investigación en Salud Pública, Escuela de Ciencias de la Salud, Universidad Pontificia Bolivariana, Medellín, Colombia.
Epidemiol Health. 2022;44:e2022069. doi: 10.4178/epih.e2022069. Epub 2022 Aug 27.
Increasing colonization by beta-lactam-resistant Gram-negative bacilli (BR-GNB) represents a risk for infections and bacterial resistance spread, both in hospitals and the community. Hemodialysis patients and their household contacts regularly transit between these environments. This study investigated the clinical and epidemiological characteristics of BR-GNB colonization in hemodialysis patients and their household contacts, as well as the genetic relationship between their isolates.
A cross-sectional study was conducted on hemodialysis patients at a hospital-associated dialysis center in Medellín, Colombia and their household contacts. Clinical and epidemiological information was collected. Colonization was assessed from stool or rectal swab samples. Bacterial identification and susceptibility were determined using chromogenic media and Vitek-2. Molecular characterization included beta-lactamase detection by polymerase chain reaction, multiple-locus sequence typing (MLST), pulsed-field gel electrophoresis, and identification of Escherichia coli phylogroups by the Clermont protocol.
This study included 36 hemodialysis patients and 90 household contacts. Colonization by BR-GNB occurred in 58.3% of patients and 22.2% of household contacts. The main beta-lactamase detected was CTX-M group-1 (40.5%). In 3 of the 9 homes that had more than 1 colonized individual, a genetic relationship was found. MLST showed a high diversity in E. coli isolates, and the most frequent phylogroups were B1 and B2.
These results show a high frequency of colonization and the presence of potentially pathogenic BR-GBN both in hospitals and the community. This highlights the importance of populations who move between those 2 environments, and the need to prevent the spread of bacterial resistance outside hospitals.
β-内酰胺类耐药革兰氏阴性杆菌（BR-GNB）定植的增加代表了医院和社区内感染和细菌耐药传播的风险。血液透析患者及其家庭接触者经常在这两种环境之间转移。本研究调查了血液透析患者及其家庭接触者中 BR-GNB 定植的临床和流行病学特征，以及其分离株之间的遗传关系。
在哥伦比亚麦德林的一家医院附属透析中心对血液透析患者及其家庭接触者进行了横断面研究。收集临床和流行病学信息。通过粪便或直肠拭子样本评估定植情况。使用显色培养基和 Vitek-2 确定细菌鉴定和药敏性。分子特征包括聚合酶链反应检测β-内酰胺酶、多位点序列分型（MLST）、脉冲场凝胶电泳和 Clermont 方案鉴定大肠埃希菌 phylogroups。
本研究包括 36 名血液透析患者和 90 名家庭接触者。58.3%的患者和 22.2%的家庭接触者发生 BR-GNB 定植。主要检测到 CTX-M 组 1（40.5%）β-内酰胺酶。在有 1 个以上定植个体的 9 个家庭中，发现了遗传关系。MLST 显示大肠杆菌分离株具有高度多样性，最常见的 phylogroups 为 B1 和 B2。
这些结果表明，医院和社区中 BR-GBN 的定植率很高，存在潜在的致病性。这突出了在这两种环境之间移动的人群的重要性，以及需要防止细菌耐药性在医院外传播。
