Research Unit Microbiology, Biomolecules and Biotechnology, Laboratory of Chemistry-Physics and Biotechnologies of Biomolecules and Materials, Faculty of Sciences and Technologies (FST), Mohammedia Hassan II University of Casablanca, Casablanca, Morocco.
Laboratory of Microbiology, Centre Hospitalo-Universitaire (CHU) Ibn Rochd, Casablanca, Morocco.
Pan Afr Med J. 2023 May 17;45:41. doi: 10.11604/pamj.2023.45.41.34457. eCollection 2023.
antimicrobial resistance in gram-negative bacilli is one of the major concerns in public health. We aimed to evaluate gram-negative bacilli epidemiology, antimicrobial profiles, and the resistance´s mechanism for Enterobacteriaceae isolated from specimens of hospitalized patients in wards of University Hospital Center Ibn Rochd of Casablanca, Morocco.
a prospective study of the patient's specimens, collected from December 2016 to 31 March 2017. Isolation and identification were performed using conventional biochemical tests. According to the European Committee on Antimicrobial Susceptibility Testing guidelines, antibiotic susceptibility was determined. Polymerase Chain Reaction (PCR) was used to detect β-lactamase and carabapenemase genes: CTX-M, SHV, TEM, OXA-48, NDM, and VIM among the Enterobacteriaceae.
according to inclusion criteria, 38 Enterobacteriaceae, 25 Acinetobacter baumannii (A. baumannii), and 10 Pseudomonas aeruginosa (P. aeruginosa) were included during the study period; these bacteria were mainly responsible for bacteremia. Fifty-five percent of enterobacteria were extended-spectrum β-lactamase (ESBL), 42% EBSL and carbapenemase, and 3% carbapenemase, with high coresistances. Eighty-four percent of A. baumannii were XDR. All P. aeruginosa were MDR; amikacin showed the best activity (70% susceptibility). The genotypic approach revealed the presence of bla, bla, bla in 68%, 22%, and 11% respectively. Of the 22 carbapenemase-producers, 41% were bla and 18% bla; none had bla. Furthermore, various genes coexistence were detected: bla+bla; bla+bla; bla+bla+bla; and bla+bla.
findings revealed highly resistance rate among isolates. This raises the need to control antibiotics and regular screening to identify dynamics promoting resistance. Thus, we recommend developing antimicrobial stewardship programs and improving hygiene systems to prevent the nosocomial spreading of these phenotypes in our center.
革兰氏阴性杆菌中的抗生素耐药性是公共卫生领域的主要关注点之一。我们旨在评估摩洛哥卡萨布兰卡伊本·罗什德大学医院中心病房住院患者标本中分离的肠杆菌科的革兰氏阴性杆菌流行病学、抗菌谱和耐药机制。
这是一项对 2016 年 12 月至 2017 年 3 月 31 日期间患者标本进行的前瞻性研究。采用常规生化试验进行分离和鉴定。根据欧洲抗菌药物敏感性试验委员会的指南，测定抗生素敏感性。聚合酶链反应（PCR）用于检测肠杆菌科中的β-内酰胺酶和碳青霉烯酶基因：CTX-M、SHV、TEM、OXA-48、NDM 和 VIM。
根据纳入标准，研究期间共纳入 38 株肠杆菌、25 株鲍曼不动杆菌（A.baumannii）和 10 株铜绿假单胞菌（P.aeruginosa）；这些细菌主要引起菌血症。55%的肠杆菌产生超广谱β-内酰胺酶（ESBL），42%产生 ESBL 和碳青霉烯酶，3%产生碳青霉烯酶，具有高度的协同耐药性。84%的 A.baumannii 是 XDR。所有 P.aeruginosa 都是 MDR；阿米卡星显示出最好的活性（70%的敏感性）。基因分型方法显示，bla、bla、bla 的存在率分别为 68%、22%和 11%。在 22 株产碳青霉烯酶的细菌中，41%是 bla，18%是 bla；均未检出 bla。此外，还检测到多种基因共存：bla+bla；bla+bla；bla+bla+bla；和 bla+bla。
研究结果显示，分离株的耐药率很高。这就需要控制抗生素的使用并定期进行筛选，以确定促进耐药性的动态。因此，我们建议在我们中心制定抗菌药物管理计划和改善卫生系统，以防止这些表型在医院内的传播。
