Department of Microbiology, Noakhali Science and Technology University, Noakhali, Bangladesh.
Braz J Microbiol. 2023 Jun;54(2):803-815. doi: 10.1007/s42770-023-00942-2. Epub 2023 Mar 11.
Humans frequently contract urinary tract infections (UTIs), which can be brought on by uropathogens (UPs) that are multi-drug resistant. Treatment for UTIs brought on by pathogenic UPs that produce extended-spectrum lactamases (ESBLs) is more costly and potentially fatal. As a result, the objective of this study was to use culture, biochemical, and 16S rRNA sequencing to identify and characterize UPs isolated from outpatients in Noakhali, Bangladesh, who had symptoms of UTIs. ESBL gene identification and quinolone resistance gene typing were then performed on the isolates using polymerase chain reaction (PCR). Throughout the trial's 8-month duration, 152 (76%) of 200 urine samples were positive for the presence of UPs. The overall number of UPs recovered was 210, with 39 individuals having multiple UPs present in their samples. Among all of the isolates, Escherichia coli (45.24%, 95/210; 95% confidence interval (CI): 35.15-57.60%), Enterobacter spp. (24.76%, 52/210; CI: 19.15-35.77%), Klebsiella spp. (20.95%; 44/210; CI: 15.15-30.20%), and Providencia spp. (9.05%; 19/210; CI: 4.95-19.25%) were the four most prevalent bacteria found in the isolates. The UPs displayed a very high level of resistance to piperacillin 96.92% (126/130), ampicillin 90% (117/130), nalidixic acid 77.69% (101/130), cefazolin 70% (91/130), amoxicillin 50% (55/130), cefazolin 42.31% (55/130), nitrofurantoin 43.08% (56/130), and ciprofloxacin 33.08% (43/130), whereas resistance to netilmicin (3.85%), amikacin (4.62%), and imipenem (9.23%) was low. Individually, every species of E. coli and Providencia spp. showed greater ampicillin, amikacin, cefazolin, cefazolin, and nalidixic acid resistance than the others. The bivariate results indicate several antibiotic pairings, and isolates had meaningful associations. All MDR isolates were subjected to PCR, which revealed that bla genes predominated among the isolates, followed by the bla class (37%). Isolates also had the qnrS, aac-6´-Ib-cr, and gyrA genes. The findings provide worrying indications of a major expansion of MDR isolates in the study locations, particularly the epidemiological bal, with the potential for the transmission of multi-drug-resistant UP strains in the population.
人类经常会感染尿路感染(UTIs),这些感染可能是由多药耐药的尿路病原体(UPs)引起的。治疗由产生超广谱β-内酰胺酶(ESBLs)的致病性 UP 引起的 UTI 更为昂贵且可能致命。因此,本研究的目的是使用培养、生化和 16S rRNA 测序来鉴定和表征来自孟加拉国诺阿卡利的门诊患者中分离出的 UP,这些患者有 UTI 症状。然后使用聚合酶链反应(PCR)对分离物进行 ESBL 基因鉴定和喹诺酮耐药基因分型。在整个 8 个月的试验期间,200 份尿液样本中有 152 份(76%)呈 UP 阳性。总共回收了 210 株 UP,其中 39 人样本中存在多种 UP。在所有分离物中,大肠杆菌(45.24%,95/210;95%置信区间(CI):35.15-57.60%)、肠杆菌属(24.76%,52/210;CI:19.15-35.77%)、肺炎克雷伯菌(20.95%,44/210;CI:15.15-30.20%)和普罗维登斯菌(9.05%,19/210;CI:4.95-19.25%)是分离物中最常见的四种细菌。这些 UP 对哌拉西林的耐药性非常高,为 96.92%(126/130),对氨苄西林的耐药性为 90%(117/130),对萘啶酸的耐药性为 77.69%(101/130),头孢唑林的耐药性为 70%(91/130),阿莫西林的耐药性为 50%(55/130),头孢唑林的耐药性为 42.31%(55/130),呋喃妥因的耐药性为 43.08%(56/130),环丙沙星的耐药性为 33.08%(43/130),而对奈替米星(3.85%)、阿米卡星(4.62%)和亚胺培南(9.23%)的耐药性较低。每一种大肠杆菌和普罗维登斯菌的个体都表现出对氨苄西林、阿米卡星、头孢唑林、头孢唑林和萘啶酸的更高耐药性。双变量结果表明,几种抗生素组合和分离物具有有意义的关联。所有 MDR 分离物均进行了 PCR 检测,结果显示 bla 基因在分离物中占主导地位,其次是 bla 类(37%)。分离物还具有 qnrS、aac-6´-Ib-cr 和 gyrA 基因。这些发现表明,研究地点的 MDR 分离物数量大幅增加,特别是流行病学球,这可能导致人群中多药耐药 UP 菌株的传播。