Mahmud Zahid Hayat, Uddin Salman Zahir, Moniruzzaman M, Ali Sobur, Hossain Monir, Islam Md Tamzid, Costa Dorin Teresa D, Islam Mohammad Rafiqul, Islam Md Shafiqul, Hassan Md Zakiul, Ong Li-Ann, Moore Catrin E, Charles Katrina J, Mondal Dinesh, Lopes Bruno Silvester, Parveen Shahana
Laboratory of Environmental Health, Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh.
Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL 32816, USA.
Pharmaceuticals (Basel). 2022 Sep 7;15(9):1116. doi: 10.3390/ph15091116.
The emergence of virulent extended spectrum β-lactamase producing (ESBL-KP) including carbapenem-resistant (CRKP) in hospital-acquired infections has resulted in significant morbidity and mortality worldwide. We investigated the antibiotic resistance and virulence factors associated with ESBL-KP and CRKP in tertiary care hospitals in Bangladesh and explored their ability to form biofilm. A total of 67 ESBL-KP were isolated from 285 isolates from environmental and patient samples from January 2019 to April 2019. For ESBL-KP isolates, molecular typing was carried out using enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR), antibiotic susceptibility testing, PCR for virulence and drug-resistant genes, and biofilm assays were also performed. All 67 isolates were multidrug-resistant (MDR) to different antibiotics at high levels and 42 isolates were also carbapenem-resistant. The most common β-lactam resistance gene was (91%), followed by (76.1%), (68.7%), (29.9%), (14.9%), (11.9%), and (4.5%). The carbapenemase genes (55.2%), (28.4%), (14.9%), (13.4%), and (10.4%) and virulence-associated genes such as (71.6%), (58.2%), (56.7%), (47.8%) and (28.4%) were also detected. About 96.2% of the environmental and 100% of the patient isolates were able to form biofilms. ERIC-PCR-based genotyping and hierarchical clustering of isolates revealed an association between environmental and patient samples, indicating clonal association with possible transmission of antimicrobial resistance genes. Our findings can help in improving patient care and infection control, and the development of public health policies related to hospital-acquired infections.
医院获得性感染中出现的产超广谱β-内酰胺酶（ESBL-KP），包括耐碳青霉烯类（CRKP），已在全球范围内导致了显著的发病率和死亡率。我们调查了孟加拉国三级医疗机构中与ESBL-KP和CRKP相关的抗生素耐药性和毒力因子，并探究了它们形成生物膜的能力。2019年1月至2019年4月期间，从环境和患者样本的285株分离株中总共分离出67株ESBL-KP。对于ESBL-KP分离株，使用肠杆菌重复基因间共识聚合酶链反应（ERIC-PCR）进行分子分型、抗生素敏感性测试、毒力和耐药基因的PCR检测，并且还进行了生物膜测定。所有67株分离株对不同抗生素均表现出高水平的多重耐药（MDR），42株分离株也耐碳青霉烯类。最常见的β-内酰胺耐药基因是（91%），其次是（76.1%）、（68.7%）、（29.9%）、（14.9%）、（11.9%）和（4.5%）。还检测到碳青霉烯酶基因（55.2%）、（28.4%）、（14.9%）、（13.4%）和（10.4%）以及毒力相关基因，如（71.6%）、（58.2%）、（56.7%）、（47.8%）和（28.4%）。约96.2%的环境分离株和100%的患者分离株能够形成生物膜。基于ERIC-PCR的分离株基因分型和层次聚类揭示了环境样本和患者样本之间的关联，表明存在克隆关联以及抗菌药物耐药基因可能的传播。我们的研究结果有助于改善患者护理和感染控制，以及制定与医院获得性感染相关的公共卫生政策。
