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产超广谱β-内酰胺酶和碳青霉烯酶的肠杆菌科细菌在感染性胸腔积液中的情况：马里医院的当前流行病学

ESBL and carbapenemase-producing Enterobacteriaceae in infectious pleural effusions: current epidemiology at Hôpital du Mali.

作者信息

Kalambry Aimé Césaire, Potindji Tchamou Malraux Fleury, Guindo Ibrehima, Kassogue Ambara, Drame Boubacar Sidiki Ibrahim, Togo Seydou, Yena Sadio, Doumbia Seydou, Diakite Mahamadou

机构信息

Medical Biology Laboratory, "Hôpital du Mali" Teaching Hospital, Bamako - Mali.

Graduate School of Biological and Food Techniques, University of Lomé, Lomé - Togo.

出版信息

Drug Target Insights. 2023 Aug 29;17:92-100. doi: 10.33393/dti.2023.2613. eCollection 2023 Jan-Dec.

DOI:10.33393/dti.2023.2613
PMID:37654725
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10466504/
Abstract

BACKGROUND

Antimicrobial resistance (AMR) is a global health concern, with extended-spectrum β-lactamases (ESBLs) and carbapenemases being major contributors. Pleural infection (PI) is a severe condition in West Africa, complicated by AMR. This study aimed to investigate the prevalence and molecular characteristics of ESBL and carbapenemase-producing enterobacteria in pleural effusions in Mali.

MATERIALS AND METHODS

Pleural fluid samples from 526 patients with pleuritis were analyzed. Enterobacterial species were isolated and identified, and the prevalence of resistance genes () and virulence factors was determined.

RESULTS

Among the patients, 110 were diagnosed with enterobacterial pleuritis. were the main pathogens identified. Resistance to β-lactams and cephalosporins was high, while carbapenems showed good activity. ESBL production was detected in 33.6% of isolates, with being the most common gene. Carbapenemase gene () was found in three isolates.

CONCLUSION

The study highlights the high prevalence of multidrug-resistant bacteria and the need for appropriate antibiotic selection based on local resistance patterns. Understanding the molecular characteristics of resistance is crucial for optimizing patient care and developing effective therapeutic strategies. Further research is needed to monitor and control AMR in PIs in Mali.

摘要

背景

抗菌药物耐药性（AMR）是一个全球关注的健康问题，超广谱β-内酰胺酶（ESBLs）和碳青霉烯酶是主要促成因素。胸膜感染（PI）在西非是一种严重疾病，因AMR而复杂化。本研究旨在调查马里胸膜积液中产ESBL和碳青霉烯酶肠杆菌的流行情况及分子特征。

材料与方法

对526例胸膜炎患者的胸水样本进行分析。分离并鉴定肠杆菌种类，确定耐药基因（）和毒力因子的流行情况。

结果

在患者中，110例被诊断为肠杆菌性胸膜炎。是鉴定出的主要病原体。对β-内酰胺类和头孢菌素类的耐药性较高，而碳青霉烯类显示出良好的活性。在33.6%的分离株中检测到ESBL产生，是最常见的基因。在三株分离株中发现了碳青霉烯酶基因（）。

结论

该研究突出了多重耐药菌的高流行率以及根据当地耐药模式进行适当抗生素选择的必要性。了解耐药的分子特征对于优化患者护理和制定有效的治疗策略至关重要。需要进一步研究以监测和控制马里PI中的AMR。