Doctorado en Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico, Mexico.
Laboratory of Experimental Bacteriology, Instituto Nacional de Pediatría, Insurgentes sur 3700-C, Col. Insurgentes Cuicuilco, Coyoacán, C.P. 04530, Mexico, Mexico.
Curr Microbiol. 2022 Oct 8;79(11):353. doi: 10.1007/s00284-022-03048-4.
Pseudomonas aeruginosa has a high adaptive capacity, favoring the selection of antibiotic-resistant strains, which are currently considered a global health problem. The purpose of this work was to investigate the rate and distribution of extensively drug-resistant (XDR) P. aeruginosa in pediatric patients with cystic fibrosis (CF) with recurrent infections and to distinguish the current efficacy of antibiotics commonly used in eradication therapy at a Mexican institute focused on children. A total of 118 P. aeruginosa isolates from 25 children with CF (2015-2019) underwent molecular identification, antimicrobial sensitivity tests, and Random Amplified Polymorphic DNA genotyping (RAPD-PCR). The bacterial isolates were grouped in 84 RAPD profiles, revealing a cross-infection between two sisters, whose resistance profile remained unchanged for more than 2 years. Furthermore, 77.1% (91/118) and 51.7% (61/118) of isolates showed in vitro susceptibility to ceftazidime and amikacin, respectively, antibiotics often used in eradication therapy at our institution. As well, 42.4% (50/118) were categorized as multi-drug resistant (MDR) and 12.7% (15/118) were XDR. Of these resistant isolates, 84.6% (55/65) were identified from patients with recurrent infections. The high frequency of XDR strains in children with CF should be considered a caution mark, as such resistance patterns are more commonly found in adult patients. Additionally, amikacin may soon prove ineffective. Careful use of available antibiotics is crucial before therapeutic possibilities are reduced and "antibiotic resistance crisis" worsens.
铜绿假单胞菌具有很强的适应能力，有利于选择抗生素耐药菌株，这些菌株目前被认为是一个全球性的健康问题。本工作的目的是研究复发性感染的囊性纤维化（CF）儿科患者中广泛耐药（XDR）铜绿假单胞菌的发生率和分布，并区分在一家专注于儿童的墨西哥研究所中常用于根除治疗的抗生素的当前疗效。对 25 名 CF 患儿（2015-2019 年）的 118 株铜绿假单胞菌分离株进行了分子鉴定、抗菌敏感性试验和随机扩增多态性 DNA 基因分型（RAPD-PCR）。细菌分离株分为 84 个 RAPD 图谱，揭示了两姐妹之间的交叉感染，其耐药谱在两年多的时间里保持不变。此外，77.1%（91/118）和 51.7%（61/118）的分离株对头孢他啶和阿米卡星分别具有体外敏感性，这两种抗生素在我们机构中常用于根除治疗。同样，42.4%（50/118）被归类为多药耐药（MDR），12.7%（15/118）为 XDR。在这些耐药分离株中，84.6%（55/65）来自复发性感染的患者。CF 患儿中 XDR 菌株的高频率应引起警惕，因为这种耐药模式在成年患者中更为常见。此外，阿米卡星可能很快就会失效。在治疗可能性降低和“抗生素耐药危机”恶化之前，谨慎使用现有抗生素至关重要。
