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阿尔及利亚斯基克达阿卜杜勒-拉扎克-布哈拉医院新生儿重症监护病房分离的革兰氏阴性菌的耐药性。

Antimicrobial Resistance Among Gram-Negative Bacteria Isolated in the Newborn Intensive Care Unit at Abderrezak-Bouhara Hospital of Skikda, Algeria.

机构信息

Research Laboratory of Interactions, Biodiversity, Ecosystems, and Biotechnology, Department of Nature and Life Sciences, University 20 August 1955, Skikda, Algeria.

Department of Biochemistry, Badji Mokhtar University, Annaba, Algeria.

出版信息

Microb Drug Resist. 2023 Jun;29(6):229-238. doi: 10.1089/mdr.2022.0254. Epub 2023 Feb 22.

Abstract

This study aimed to determine the epidemiology of gram-negative bacteria (GNB) isolated in the newborn intensive care unit (NICU) population, to assess their antibiotic susceptibility patterns and possible associated risk factors. All neonates admitted to the NICU of Abderrezak-Bouhara hospital (Skikda, Algeria) with a clinical diagnosis of neonatal infections from March to May 2019 were included in the study. The extended-spectrum β-lactamase ESBLs), plasmidic cephalosporinase (pAmpC), and carbapenemases genes were screened by polymerase chain reaction (PCR) and sequencing. PCR amplification of among carbapenem-resistant isolates was also performed. The clonal relatedness of the ESBLs isolates was studied using multilocus sequence typing MLST). Among 148 clinical specimens, 36 (24.3%) GNB strains were isolated from urine ( = 22), wound ( = 8), stool ( = 3), and blood ( = 3) samples. The bacterial species identified were ( = 13), ( = 5), ( = 3), ( = 3), spp. ( = 3), ( = 1), ( = 5), and ( = 3). PCR and sequencing showed that eleven isolates harbored the gene, two isolates harbored the gene, and three isolates harbored both and genes. Also, five strains of were found to harbor mutations in the gene. MLST showed that the strains belonged to ST13 and ST189, belonged to ST69, and belonged to ST214. Different risk factors that could predict positive GNB cultures were found, including female sex, Apgar score <8 at 5 min of life, enteral nutrition, antibiotic use, and extended length of hospitalization. Our study highlights the importance of determining the epidemiology of pathogens causing neonatal infections, their sequence types (ST), and their antibiotic susceptibility patterns to address rapidly a correct antibiotic treatment regimen.

摘要

本研究旨在确定新生儿重症监护病房(NICU)人群中分离出的革兰氏阴性菌(GNB)的流行病学情况,评估其抗生素敏感性模式和可能的相关危险因素。2019 年 3 月至 5 月期间,所有因临床诊断为新生儿感染而入住阿尔及利亚斯基克达的阿卜杜勒-拉扎克-布哈拉医院 NICU 的新生儿均纳入本研究。通过聚合酶链反应(PCR)和测序筛选超广谱β-内酰胺酶(ESBLs)、质粒头孢菌素酶(pAmpC)和碳青霉烯酶基因。对耐碳青霉烯类的 株也进行了 PCR 扩增。使用多位点序列分型(MLST)研究 ESBLs 分离株的克隆相关性。在 148 份临床标本中,从尿液(22 份)、伤口(8 份)、粪便(3 份)和血液(3 份)样本中分离出 36 株(24.3%)GNB 菌株。鉴定出的细菌种类包括 (13 株)、 (5 株)、 (3 株)、 (3 株)、 spp.(3 株)、 (1 株)、 (5 株)和 (3 株)。PCR 和测序显示,11 株 分离株携带 基因,2 株 分离株携带 基因,3 株 分离株同时携带 和 基因。此外,发现 5 株 株携带 基因的突变。MLST 显示, 株属于 ST13 和 ST189, 株属于 ST69, 株属于 ST214。还发现了一些可预测 GNB 阳性培养的危险因素,包括女性、出生后 5 分钟时的 Apgar 评分<8、肠内营养、抗生素使用和延长住院时间。本研究强调了确定引起新生儿感染的病原体的流行病学情况、其序列类型(ST)和抗生素敏感性模式的重要性,以便迅速制定正确的抗生素治疗方案。

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