Department of Laboratory Medicine, Faculty of Medicine, Medical Academy, Lithuanian University of Health Science, Eivenių g. 2, LT-50161 Kaunas, Lithuania.
Medicina (Kaunas). 2023 Jul 28;59(8):1386. doi: 10.3390/medicina59081386.
: () is an important nosocomial pathogen that not only possesses intrinsic resistance to many classes of antibiotics, but is also capable of rapidly developing antimicrobial resistance during treatment. The aim of this study was to determine the characteristics of resistance of strains to -lactams and other tested antibiotics, to evaluate the associations between the phenotypes of resistance to -lactams and other tested antibiotics, and to evaluate the changes in antibiotic resistance of strains over 5 years by comparing the periods of 2016-2017 and 2020-2021. A total of 233 strains were isolated from different clinical specimens of patients treated at the Hospital of Lithuanian University of Health Sciences in 2016-2017 ( = 130) and 2021-2022 ( = 103). All clinical cultures positive for were analyzed. The type of -lactamase was detected by phenotypic methods using ESBL plus AmpC screen disk tests and the combination meropenem disk test. In both periods, all strains were resistant to ciprofloxacin; resistance to carbapenems, piperacillin/tazobactam, gentamicin, and tobramycin was noted in more than 80% of strains. A comparison of two periods showed that the percentages of strains producing two or three types of -lactamases were significantly greater in 2021-2022 than in 2016-2017 (94.2% and 5.8% vs. 17.7% and 2.3%, respectively, < 0.001). Isolates producing two or three types of -lactamases were more often resistant to tigecycline, tetracycline, and doxycycline than strains producing one type of -lactamase ( < 0.001). The frequency of isolation of strains producing two different types of -lactamases (AmpC plus KPC, AmpC plus ESBL, or ESBL plus KPC) or three types of -lactamases (AmpC, KPC, and ESBL) and the resistance rates to ampicillin/sulbactam, tigecycline, tetracycline, and doxycycline were significantly greater in 2020-2021 as compared with 2016-2017. The production of two or three types of -lactamases by strains was associated with higher resistance rates to tetracyclines.
(肠杆菌科)是一种重要的医院病原体,它不仅对许多类抗生素具有固有耐药性,而且在治疗过程中还能够迅速产生抗微生物药物耐药性。本研究的目的是确定 菌株对 -内酰胺类和其他测试抗生素的耐药特征,评估 -内酰胺类和其他测试抗生素耐药表型之间的相关性,并通过比较 2016-2017 年和 2020-2021 年两个时期来评估 菌株 5 年来抗生素耐药性的变化。从立陶宛健康科学大学医院治疗的患者的不同临床标本中分离出 233 株 株 2016-2017 年( = 130)和 2021-2022 年( = 103)。对所有临床培养阳性的 进行分析。通过使用 ESBL 加 AmpC 筛选盘试验和组合美罗培南盘试验的表型方法检测 -内酰胺酶的类型。在两个时期,所有 株均对环丙沙星耐药;超过 80%的菌株对碳青霉烯类、哌拉西林/他唑巴坦、庆大霉素和妥布霉素耐药。两个时期的比较表明,2021-2022 年产生两种或三种 -内酰胺酶的 株的百分比明显高于 2016-2017 年(分别为 94.2%和 5.8%比 17.7%和 2.3%, < 0.001)。产生两种或三种 -内酰胺酶的分离株对替加环素、四环素和多西环素的耐药率明显高于产生一种 -内酰胺酶的分离株( < 0.001)。2020-2021 年与 2016-2017 年相比,产生两种不同类型 -内酰胺酶(AmpC 加 KPC、AmpC 加 ESBL 或 ESBL 加 KPC)或三种类型 -内酰胺酶(AmpC、KPC 和 ESBL)的 株的分离率以及对氨苄西林/舒巴坦、替加环素、四环素和多西环素的耐药率均显著增加。 株产生两种或三种 -内酰胺酶与对四环素的更高耐药率相关。