尼日利亚中北部地区菌血症患儿侵袭性细菌的抗菌耐药性及毒力基因

Antimicrobial resistance and virulence genes of invasive from children with bacteremia in north-central Nigeria.

作者信息

Uzairue Leonard I, Shittu Olufunke B, Ojo Olufemi E, Obuotor Tolulope M, Olanipekun Grace, Ajose Theresa, Arogbonlo Ronke, Medugu Nubwa, Ebruke Bernard, Obaro Stephen K

机构信息

Department of Microbiology, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria.

International Foundation Against Infectious Disease in Nigeria, Abuja, Nigeria.

出版信息

SAGE Open Med. 2023 May 20;11:20503121231175322. doi: 10.1177/20503121231175322. eCollection 2023.

OBJECTIVES

Bacteremia due to invasive has been reported earlier in children in Nigeria. This study aimed to detect the virulence and antibiotic resistance genes of invasive from children with bacteremia in north-central Nigeria.

METHOD

From June 2015 to June 2018, 4163 blood cultures yielded 83 isolates. This is a secondary cross-sectional analysis of the isolates. The were isolated and identified using standard bacteriology protocol. Biochemical identifications of the were made by Phoenix MD 50 identification system. Further identification and confirmation were done with polyvalent antisera O and A gene. Antimicrobial susceptibility testing was done following clinical and laboratory standard institute guidelines. Resistant genes and virulence genes were determined using a real-time polymerase chain reaction.

RESULT

51 (61.4%) was the most prevalent serovar, followed by species 13 (15.7%), 8 (9.6%), 6 (7.2%), and 5 (6.1%). Fifty-one (61.4%) of 83 were typhoidal, while 32 (38.6%) were not. Sixty-five (78.3%) of the 83 isolates were resistant to ampicillin and trimethoprim-sulfamethoxazole, followed by chloramphenicol 39 (46.7%), tetracycline 41 (41.4%), piperacillin 33 (33.9%), amoxicillin-clavulanate, and streptomycin 21 (25.3%), while cephalothin was 19 (22.9%). Thirty-nine (46.9%) of the 83 isolates were multi-drug resistant, and none were extensive drug resistant or pan-drug resistant. A 42 (50.6%), R 32 (38.6%), A 24 (28.9%), B 20 (20.1%), A 10 (10.0%), and G 5 (6.0%) were the antibiotic resistance genes detected. There were perfect agreement between phenotypic and genotypic detection of antimicrobial resistance in tetracycline, ciprofloxacin, and chloramphenicol, while beta-lactam showed κ = 0.60 agreement. All of the isolates had the virulence genes A, B, C, and 4D, while 33 (39.8%), 45 (51.8%), and 2 (2.4%) had Q, C, and GI-1, respectively.

CONCLUSION

Our findings showed multi-drug resistant in children with bacteremia in northern Nigeria. In addition, significant virulence and antimicrobial resistance genes were found in invasive in northern Nigeria. Thus, our study emphasizes the need to monitor antimicrobial resistance in from invasive sources in Nigeria and supports antibiotic prudence.

目的

尼日利亚儿童侵袭性[具体细菌名称未给出]所致菌血症此前已有报道。本研究旨在检测尼日利亚中北部菌血症患儿侵袭性[具体细菌名称未给出]的毒力基因和抗生素耐药基因。

方法

2015年6月至2018年6月，4163份血培养分离出83株[具体细菌名称未给出]菌株。这是对这些分离菌株的二次横断面分析。采用标准细菌学方案分离和鉴定[具体细菌名称未给出]。通过Phoenix MD 50鉴定系统对[具体细菌名称未给出]进行生化鉴定。使用多价抗血清O和A基因进行进一步鉴定和确认。按照临床和实验室标准协会指南进行抗菌药物敏感性试验。使用实时聚合酶链反应确定耐药基因和毒力基因。

结果

51型（61.4%）是最常见的血清型，其次是[具体细菌名称未给出]种13型（15.7%）、[具体细菌名称未给出]型8型（9.6%）、[具体细菌名称未给出]型6型（7.2%）和[具体细菌名称未给出]型5型（6.1%）。83株[具体细菌名称未给出]中有51株（61.4%）为伤寒型，32株（38.6%）为非伤寒型。83株[具体细菌名称未给出]分离株中有65株（78.3%）对氨苄西林和甲氧苄啶 - 磺胺甲恶唑耐药，其次是氯霉素39株（46.7%）、四环素41株（41.4%）、哌拉西林33株（33.9%）、阿莫西林 - 克拉维酸和链霉素21株（25.3%），而头孢噻吩为19株（22.9%）。83株[具体细菌名称未给出]分离株中有39株（46.9%）对多种药物耐药，无广泛耐药或全耐药菌株。检测到的抗生素耐药基因有A 42株（50.6%）、R 32株（38.6%）、A 24株（28.9%）、B 20株（20.1%）、A 10株（10.0%）和G 5株（6.0%）。在四环素、环丙沙星和氯霉素的抗菌药物耐药性表型和基因型检测之间存在完全一致性，而β - 内酰胺类显示κ = 0.60的一致性。所有[具体细菌名称未给出]分离株均具有毒力基因A、B、C和4D，而分别有33株（39.8%）、45株（51.8%）和2株（2.4%）具有Q、C和GI - 1基因。