喀麦隆巴门达市临床和人畜共患病源分离的 菌株对碳青霉烯类药物的敏感性降低和抗菌药物耐药谱。
Reduced susceptibility to carbapenems in and antimicrobial resistance profile of strains isolated from clinical and zoonotic sources in the Bamenda Municipality, Cameroon.
机构信息
Department of Biomedical Sciences, University of Bamenda, P.O. Box 39, Bambili, Cameroon.
Department of Medical Laboratory Science, University of Bamenda, P.O. Box 39, Bamenda, Cameroon.
出版信息
Pan Afr Med J. 2023 Feb 16;44:90. doi: 10.11604/pamj.2023.44.90.31326. eCollection 2023.
INTRODUCTION
food-producing animals harbour pathogenic and antibiotic resistant bacteria which can be transmitted to humans. Resistance to carbapenems may complicate treatment resulting to debilitating consequences. This study aimed at determining the susceptibility of Enterobacteriaceae to carbapenems and to compare the resistant patterns of E. coli strains isolated from clinical and zoonotic sources.
METHODS
this was a cross-sectional study involving patients presenting at the Bamenda Regional Hospital and abattoir samples. Clinical samples (faeces and urine) and zoonotic samples (cattle faeces) were cultured and isolates identified using API-20E. Enterobacteriaceae isolates were tested for their susceptibility to Carbapenems. The susceptibility of E. coli was tested against eight antibiotics on Mueller Hinton agar. Data was analysed using SPSS version 20.
RESULTS
Enterobacteriaceae isolates from clinical specimen showed susceptibility of 93.3% to carbapenems. Out of 208 isolates 14 (6.7%) were Carbapenem-resistant Enterobacteriaceae (CRE) while 30 (14.4%) showed intermediate resistance and 164 (78.9%) were susceptible. The predominant CRE were Proteus (7/16, 43.8%), Providencia (3/15, 20.0%) and E. coli (4/60, 6.7%) with E. coli being the most clinically significant CRE. Multiple drug resistance (MDR) was observed in 83% of E. coli isolates, with the highest resistance being against vancomycin (90, 81.8%), azithromycin (69, 62.7%) and doxycycline (68, 61.8%). Clinical isolates were significantly (P<0.05) more resistant to azithromycin, trimethoprim-suphamethoxazole and gentamicin than zoonotic isolates.
CONCLUSION
CRE were detected among isolates and a high rate of multiple drug resistance was observed among E. coli isolates. Proper antibiotic policies and good hygiene/sanitation measures may curb the development/spread of CRE and MDR E. coli.
简介
食用动物携带的致病和耐药细菌可传播给人类。对碳青霉烯类药物的耐药性可能使治疗复杂化，导致身体虚弱等后果。本研究旨在确定肠杆菌科对碳青霉烯类药物的敏感性，并比较从临床和动物源分离的大肠杆菌菌株的耐药模式。
方法
这是一项涉及在班马纳地区医院和屠宰场样本中就诊的患者的横断面研究。临床样本（粪便和尿液）和动物源样本（牛粪便）进行培养，并使用 API-20E 进行鉴定。肠杆菌科分离株对碳青霉烯类药物的敏感性进行测试。在 Mueller Hinton 琼脂上用 8 种抗生素测试大肠杆菌的敏感性。使用 SPSS 版本 20 分析数据。
结果
来自临床标本的肠杆菌科分离株对碳青霉烯类药物的敏感性为 93.3%。在 208 株分离株中，14 株（6.7%）为耐碳青霉烯肠杆菌科（CRE），30 株（14.4%）为中介耐药，164 株（78.9%）为敏感。主要的 CRE 是普罗维登斯菌（16 株中的 7 株，43.8%）、变形杆菌（15 株中的 3 株，20.0%）和大肠杆菌（60 株中的 4 株，6.7%），其中大肠杆菌是最具临床意义的 CRE。83%的大肠杆菌分离株表现出多重耐药（MDR），对万古霉素（90 株，81.8%）、阿奇霉素（69 株，62.7%）和强力霉素（68 株，61.8%）的耐药性最高。临床分离株对阿奇霉素、复方磺胺甲噁唑和庆大霉素的耐药性明显（P<0.05）高于动物源分离株。
结论
在分离株中检测到 CRE，并且大肠杆菌分离株中观察到很高的多重耐药率。适当的抗生素政策和良好的卫生/环境卫生措施可能会抑制 CRE 和多重耐药大肠杆菌的发展/传播。
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