Ajani T A, Elikwu C J, Anaedobe C G, Onwuzo C N, Tayo B, Okangba C C, Makanjuola O B
Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria.
Department of Medical Microbiology, Benjamin Carson (Snr) College of Health and Medical Sciences, Babcock University, Ilisan Remo, Nigeria.
Ann Ib Postgrad Med. 2022 Dec;20(2):160-168.
Molecular diagnosis though faster and more sensitive than phenotypic techniques, is more expensive. Resource limited settings are thus limited to using more of phenotypic rather than molecular methods in the routine detection of Extended Spectrum beta lactamases (ESBL).
This study aimed to evaluate the performance of double disc synergy test (DSST) and Epsilometer (E) test with Polymerase Chain Reaction (PCR) and to detect the risk factors associated with ESBL producing organisms among in-patients at Babcock University Teaching Hospital, Ilishan-Remo, Nigeria.
Hospital-based cross-sectional study in which bacterial isolates of 165 in-patients were collected fromMarch 2018 to September 2019. The isolates were evaluated for ESBL production by the use of DDST, Etest and PCR. The performance evaluation was done. Questionnaire was used to assess the risk factors associated with ESBL, IBM SPSS Version 23 was used to analyze the data.
The participants' isolates yielded 50/165 (30.3%) that were ESBL positive by DDST, 47/165 (28.9%) by E-test and 48/165(29.1%) by PCR. Sensitivity and specificity of DSST was 100% and 98.3% while that of E-test was 98% and 100% respectively. Age, antibiotics intake without prescription, being on ventilator, urethral catheterization and nasogastric tubes were all significantly associated with presence of ESBL (p value <0.05).
Phenotypic tests remain reliable for the routine detection of ESBL in the absence of molecular methods. Rational use of instrumentation and antibiotics is advocated based on the risk factors detected from this study.
分子诊断虽然比表型技术更快、更灵敏，但成本更高。因此，在资源有限的环境中，在常规检测超广谱β-内酰胺酶（ESBL）时，更多地使用表型而非分子方法。
本研究旨在评估双纸片协同试验（DSST）和Epsilometer（E）试验与聚合酶链反应（PCR）的性能，并检测尼日利亚伊莱山-雷莫巴科克大学教学医院住院患者中产ESBL菌株的相关危险因素。
基于医院的横断面研究，于2018年3月至2019年9月收集了165例住院患者的细菌分离株。通过使用双纸片协同试验、E试验和PCR对分离株进行ESBL产生情况评估。进行了性能评估。采用问卷调查评估与ESBL相关的危险因素，使用IBM SPSS 23版分析数据。
参与者的分离株中，双纸片协同试验检测出50/165（30.3%）为ESBL阳性，E试验检测出47/（28.9%）为阳性，PCR检测出48/165（29.1%）为阳性。双纸片协同试验的敏感性和特异性分别为100%和98.3%，而E试验的敏感性和特异性分别为98%和100%。年龄、无处方使用抗生素、使用呼吸机、尿道插管和鼻胃管均与ESBL的存在显著相关（p值<0.05）。
在没有分子方法的情况下，表型试验对于ESBL的常规检测仍然可靠。基于本研究检测到的危险因素，提倡合理使用仪器和抗生素。
