烧伤创面耐多药铜绿假单胞菌 T3SS（exoS、exoT、exoU 和 exoY）的存在、药敏模式及 MIC。

Presence of T3SS (exoS, exoT, exoU and exoY), susceptibility pattern and MIC of MDR-Pseudomonas aeruginosa from burn wounds.

机构信息

Pure Lab, Pure Health, Abu Dhabi, United Arab Emirates.

Department of Microbiology, Sarhad University of Science and Information Technology, Peshawar, KP, Pakistan.

出版信息

J Infect Dev Ctries. 2023 Aug 31;17(8):1130-1137. doi: 10.3855/jidc.17580.

DOI:10.3855/jidc.17580

PMID:37699096

Abstract

INTRODUCTION

The emergence of resistance is a major public health and clinical issue, particularly in pathogens causing nosocomial infections. Recently, there is the emergence of Pseudomonas aeruginosa resistance to different broad-spectrum antibiotics.

METHODOLOGY

The current study was designed to find out the prevalence of multi-drug resistant (MDR) P. aeruginosa in burn patients, the antibiotic susceptibility pattern of MDR Pseudomonas, and to determine the Minimum Inhibitory Concentration (MIC) of the effective antimicrobials. The assessment of virulence genes (exoT, exoS, exoY and exoU) was also achieved through PCR. In the current study wound swabs were collected from 160 burn patients from two burn units (MTI-Govt. Lady Reading Hospital and MTI-Khyber Teaching Hospital).

RESULTS

Out of these 160 samples, 26 samples (16.25%) were positive for P. aeruginosa. Per patients, one isolate was included in the current study. Antibiotic susceptibility pattern showed all P. aeruginosa isolates were 100% resistant to amoxicillin-clavulanic acid, 84.62% resistance to Cefepime, and Ceftazidime, and 76.92% resistance to Amikacin, Aztreonam, and Ciprofloxacin. Whereas the lowest resistance was observed to Imipenem and Piperacillin-Tazobactam (53.85%), Colistin Sulfate (23.08%), and Polymyxin-B (15.38%). Regarding the prevalence of MDR, 22 (84.61%) isolates out of 26 were found to be MDR-P. aeruginosa. For MDR-P. aeruginosa, the MIC range was 1-2 µg/mL against Polymyxin-B, 2-8 µg/mL against Colistin sulfate, 16-1024 µg/mL against Imipenem and 128-1024 µg/mL against Piperacillin-Tazobactam. 100% of the isolates carried exoT, 88.46% carried exoY, and 57.69% and 38.46% carried exoU and exoS, respectively.

CONCLUSIONS

These findings further emphasize the need for antibiotic discipline and to follow the recommended hospital antibiotic policy to prevent the proliferation of MDR strains of P. aeruginosa in the community.

摘要

简介

耐药性的出现是一个主要的公共卫生和临床问题，特别是在引起医院感染的病原体中。最近，铜绿假单胞菌对不同广谱抗生素的耐药性有所增加。

方法

本研究旨在调查烧伤患者中多药耐药（MDR）铜绿假单胞菌的流行情况、MDR 铜绿假单胞菌的抗生素药敏模式，并确定有效抗菌药物的最低抑菌浓度（MIC）。还通过 PCR 检测了毒力基因（exoT、exoS、exoY 和 exoU）。在本研究中，从两个烧伤单位（MTI-政府莱德夫人医院和 MTI-开伯尔教学医院）的 160 名烧伤患者中采集了伤口拭子。

结果

在这 160 个样本中，有 26 个样本（16.25%）为铜绿假单胞菌阳性。每个患者纳入一个分离株进行研究。抗生素药敏模式显示，所有铜绿假单胞菌分离株对阿莫西林克拉维酸 100%耐药，对头孢吡肟和头孢他啶 84.62%耐药，对阿米卡星、氨曲南和环丙沙星 76.92%耐药。而对亚胺培南和哌拉西林他唑巴坦（53.85%）、硫酸多粘菌素 B（23.08%）和多粘菌素 B（15.38%）的耐药性最低。关于 MDR 的流行情况，26 个样本中有 22 个（84.61%）被发现为 MDR-铜绿假单胞菌。对于 MDR-铜绿假单胞菌，多粘菌素 B 的 MIC 范围为 1-2 µg/mL，硫酸多粘菌素 B 的 MIC 范围为 2-8 µg/mL，亚胺培南的 MIC 范围为 16-1024 µg/mL，哌拉西林他唑巴坦的 MIC 范围为 128-1024 µg/mL。100%的分离株携带 exoT，88.46%携带 exoY，57.69%和 38.46%分别携带 exoU 和 exoS。