Durán-Manuel Emilio Mariano, Bello-López Juan Manuel, Salinas-Bobadilla Aranza Denisse, Vargas-De-León Cruz, Nieto-Velázquez Nayeli Goreti, Moreno-Eutimio Mario Adán, Pastelin-Palacios Rodolfo, Calzada-Mendoza Claudia Camelia, Blanco-Hernández Dulce Milagros Razo
Hospital Juárez de México, Mexico City 07760, Mexico.
Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico.
Pathogens. 2023 Oct 29;12(11):1294. doi: 10.3390/pathogens12111294.
Empirical use of antibiotics in the treatment of eye infections leads to bacterial pathogens becoming resistant to antibiotics; consequently, treatment failure and eye health complications occur. The aim of this study was to describe the phenotype and genotype of the resistance and adherence of bacterial agents causing eye infections in patients at Hospital Juárez de México. An observational, prospective, cross-sectional, and descriptive study was carried out in patients with signs and symptoms of ocular infection. Bacterial agents were isolated and identified by classical microbiology and mass spectrometry. Antibiotic resistance and adherence profiles were determined. Finally, resistance (/) and virulence ( and ) genes were detected in the Gram-positive population. The results showed that blepharitis was the most prevalent condition in the study population. A MALDI-TOF analysis revealed that and genus were the most prevalent as causal agents of infection. Resistances to β-lactams were detected of 44 to 100%, followed by clindamycins, aminoglycosides, folate inhibitors, and nitrofurans. A multiple correspondence analysis showed a relationship between genotype and β-lactams resistance. The identification of and elements suggested community and hospital sources of infection. Finally, the coexistence of //() and //() genotypes was detected in . . The identification of resistant and virulent isolates highlights the importance of developing protocols that address the timely diagnosis of ocular infections. Herein, implications for the failure of antimicrobial therapy in the treatment of ocular infections in susceptible patients are analysed and discussed.
在眼部感染治疗中经验性使用抗生素会导致细菌病原体对抗生素产生耐药性；因此，会出现治疗失败和眼部健康并发症。本研究的目的是描述墨西哥胡亚雷斯医院患者眼部感染细菌病原体的耐药表型和基因型以及黏附情况。对有眼部感染体征和症状的患者进行了一项观察性、前瞻性、横断面描述性研究。通过经典微生物学和质谱法分离并鉴定细菌病原体。确定抗生素耐药性和黏附情况。最后，在革兰氏阳性菌群体中检测耐药（/）和毒力（和）基因。结果显示睑缘炎是研究人群中最常见的病症。基质辅助激光解吸电离飞行时间质谱（MALDI-TOF）分析显示，属和属是最常见的感染病原体。检测到对β-内酰胺类抗生素的耐药率为44%至100%，其次是克林霉素、氨基糖苷类、叶酸抑制剂和硝基呋喃。多重对应分析显示基因型与β-内酰胺类抗生素耐药性之间存在关联。和元件的鉴定表明存在社区感染源和医院感染源。最后，在……中检测到//()和//()基因型的共存。耐药和有毒力菌株的鉴定凸显了制定及时诊断眼部感染方案的重要性。在此，分析并讨论了抗菌治疗在易感患者眼部感染治疗中失败的影响因素。
