Laboratoire de Lutte Contre les Maladies Infectieuses, Faculty of Medicine and Pharmacy, University Cadi Ayyad, Marrakesh 40000, Morocco.
Laboratory of Microbiology-Virology of Ar-Razi Hospital, Mohammed VI University Hospital Centre, BP 2360, Marrakesh, Morocco.
Lett Appl Microbiol. 2023 Sep 1;76(9). doi: 10.1093/lambio/ovad107.
Enterobacterales are frequently a major cause of human infections. The emergence of carbapenem resistance as well as the biofilm formation complicate their management. In this regard, this study aimed to investigate the prevalence, antibiogram, carbapenemase genes, and biofilm production among Enterobacterales. For this purpose, 18 172 clinical specimens from hospitalized patients at Mohammed VI University Hospital were collected over two years (2018-2019). The bacteriological investigation was performed to isolate Enterobacterales. Subsequently, BD-Phoenix and MALDI-TOF-MS were used for bacterial identification. The production of ESBLs and carbapenemases was assessed using phenotypic tests and PCR. The biofilm formation was eventually carried out. Out of 195 carbapenem-resistant Enterobacterales strains, 190 were carbapenemase producers, and 74 Enterobacterales produced metallo-beta-lactamases (MBLs). The PCR results revealed that blaNDM was the most common carbapenemase gene, present in 62 cases, followed by the co-existence of blaNDM and blaOXA-48 in 12 cases. Klebsiella pneumoniae was the most frequently identified species among the 74 New Delhi metallo-β-lactamase (NDM) isolates and the XDR resistance phenotype was the most prevalent with 58.10%. Additionally, all 74 NDM-positive Enterobacterales were able to form biofilms, with 82.4% being strong producers. This study highlights the need for rapid detection of carbapenemase and biofilm production in our hospital to manage this health concern.
肠杆菌科经常是人类感染的主要原因。碳青霉烯耐药性的出现以及生物膜的形成使它们的管理变得复杂。在这方面，本研究旨在调查肠杆菌科的流行率、抗生素敏感性、碳青霉烯酶基因和生物膜产生情况。为此，在两年（2018-2019 年）内收集了 Mohammed VI 大学医院住院患者的 18172 份临床标本。进行细菌学调查以分离肠杆菌科。随后，使用 BD-Phoenix 和 MALDI-TOF-MS 进行细菌鉴定。使用表型试验和 PCR 评估 ESBL 和碳青霉烯酶的产生。最终进行生物膜形成。在 195 株耐碳青霉烯肠杆菌中，190 株为碳青霉烯酶产生菌，74 株肠杆菌产生金属β-内酰胺酶（MBLs）。PCR 结果显示，blaNDM 是最常见的碳青霉烯酶基因，存在于 62 例中，其次是 blaNDM 和 blaOXA-48 共存 12 例。肺炎克雷伯菌是 74 株新德里金属β-内酰胺酶（NDM）分离株中最常鉴定的种，XDR 耐药表型最常见，为 58.10%。此外，所有 74 株 NDM 阳性肠杆菌均能形成生物膜，其中 82.4%为强产生者。本研究强调了在我们医院快速检测碳青霉烯酶和生物膜产生的必要性，以应对这一健康问题。
