Akinduti Paul A, George Onome W, Ohore Hannah U, Ariyo Olusegun E, Popoola Samuel T, Adeleye Adenike I, Akinwande Kazeem S, Popoola Jacob O, Rotimi Solomon O, Olufemi Fredrick O, Omonhinmin Conrad A, Olasehinde Grace I
Microbiology Unit, Department of Biological Sciences, Covenant University, PMB 1023, Ota 112104, Ogun State, Nigeria.
Obasanjo Holdings Limited, Abeokuta 110124, Ogun State, Nigeria.
Antibiotics (Basel). 2023 Mar 22;12(3):626. doi: 10.3390/antibiotics12030626.
is a significant pathogen identified with healthcare-associated infections. The present study evaluates the role of biofilm and efflux pump activities in influencing high-level resistance in virulent strains in clinical infection. Phenotypic resistance in biotyped ( = 147) from diagnosed disease conditions was classified based on multiple antibiotic resistance (MAR) indices and analysed with logistic regression for risk factors. Efflux pump activity, biofilm formation, and virulence factors were analysed for optimal association in infection using receiver operation characteristics (ROC). Age-specificity (OR [CI] = 0.986 [0.946-1.027]), gender (OR [CI] = 1.44 [0.211-9.827]) and infection sources (OR [CI] = 0.860 [0.438-1.688]) were risk variables for multidrug resistance (MDR)- infection ( < 0.05). Biofilm formers caused 48.2% and 18.5% otorrhea and wound infections (95% CI = 0.820-1.032; = 0.001) respectively and more than 30% multidrug resistance (MDR) strains demonstrated high-level efflux pump activity (95% CI = 0.762-1.016; = 0.001), protease (95% CI = 0.112-0.480; = 0.003), lipase (95% CI = 0.143-0.523; = 0.001), and hemolysin (95% CI = 1.109-1.780; = 0.001). Resistance relatedness of more than 80% and 60% to cell wall biosynthesis inhibitors (ceftazidime, ceffproxil, augumentin, ampicillin) and, DNA translational and transcriptional inhibitors (gentamicin, ciprofloxacin, ofloxacin, nitrofurantoin) were observed ( < 0.05). Strong efflux correlation (r = 0.85, = 0.034) with MDR strains, with high predictive performances in efflux pump activity (ROC-AUC 0.78), biofilm formation (ROC-AUC 0.520), and virulence hierarchical-clustering. Combine activities of the expressed efflux pump and biofilm formation in MDR- pose risk to clinical management and infection control.
是一种与医疗保健相关感染相关的重要病原体。本研究评估生物膜和外排泵活性在临床感染中影响强毒株高水平耐药性方面的作用。根据多重耐药（MAR）指数对来自确诊疾病状况的147株生物分型菌株的表型耐药性进行分类，并通过逻辑回归分析危险因素。使用受试者工作特征（ROC）分析感染中外排泵活性、生物膜形成和毒力因子的最佳关联。年龄特异性（OR[CI]=0.986[0.946 - 1.027]）、性别（OR[CI]=1.44[0.211 - 9.827]）和感染源（OR[CI]=0.860[0.438 - 1.688]）是多重耐药（MDR）感染的风险变量（P<0.05）。形成生物膜的菌株分别导致48.2%的耳漏和18.5%的伤口感染（95%CI = 0.820 - 1.032；P = 0.001），超过30%的多重耐药（MDR）菌株表现出高水平的外排泵活性（95%CI = 0.762 - 1.016；P = 0.001）、蛋白酶（95%CI = 0.112 - 0.480；P = 0.003）、脂肪酶（95%CI = 0.143 - 0.523；P = 0.001）和溶血素（95%CI = 1.109 - 1.780；P = 0.001）。观察到对细胞壁生物合成抑制剂（头孢他啶、头孢丙烯、奥硝唑、氨苄青霉素）以及DNA翻译和转录抑制剂（庆大霉素、环丙沙星、氧氟沙星、呋喃妥因）的耐药相关性分别超过80%和60%（P<0.05）。与MDR菌株有很强的外排相关性（r = 0.85，P = 0.034），在外排泵活性（ROC - AUC 0.78）、生物膜形成（ROC - AUC 0.520）和毒力层次聚类方面具有较高的预测性能。MDR中表达的外排泵和生物膜形成的联合活性对临床管理和感染控制构成风险。
