Moussa Benboubker, Hmami Fouzia, Arhoun Btissam, El Fakir Samira, Massik Abdelhamid M, Belchkar Salim, Hibaoui Lahbib, Oumokhtar Bouchra
Human Pathology Biomedicine and Environment Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, MAR.
Neonatal Intensive Care Unit, University Hospital Hassan II, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, MAR.
Cureus. 2023 Dec 7;15(12):e50095. doi: 10.7759/cureus.50095. eCollection 2023 Dec.
This study aimed to investigate the prevalence and the carbapenemase production ability of Klebsiella pneumoniae isolates from premature neonates' intestinal tracts in a Moroccan neonatal intensive care unit Methodology: Active rectal screening was performed among 339 preterm infants. The collected isolates were subjected to antibiotic susceptibility testing, phenotypic analysis of carbapenemase production, and molecular detection of carbapenemase genes.
Out of 293 K. pneumoniae isolates collected, 31.05% (91) were resistant to carbapenem and produced carbapenemase, resulting in a 22.12% rate of intestinal carriage. Among the carbapenem-resistant K. pneumoniae isolates, 40.65% (37) had co-harbored carbapenemase genes. All isolates contained the blaOXA-48 gene, and the blaNDM, blaVIM, and blaKPC genes were detected in 30.76%, 9.89%, and 2.19% of the isolates, respectively. Out of 30.76% of these isolates had both the blaOXA-48 and blaNDM genes, 8.79% had both blaOXA-48 and blaVIM, and only 2.20% had both blaOXA-48 and blaKPC genes. Furthermore, 88.57% of carbapenem-resistantK. pneumoniae isolates co-harboring carbapenemase genes were genetically related strains.
This study revealed a high prevalence of intestinal carriage of carbapenem-resistant K. pneumoniae. Therefore, implementing effective screening and diagnostic measures, and focusing on antimicrobial stewardship are essential to preventing the spread of these resistant strains and minimizing the risk they pose to premature infants.
本研究旨在调查摩洛哥新生儿重症监护病房中早产新生儿肠道肺炎克雷伯菌分离株的流行情况及其碳青霉烯酶产生能力。方法：对339名早产儿进行主动直肠筛查。对收集到的分离株进行药敏试验、碳青霉烯酶产生的表型分析以及碳青霉烯酶基因的分子检测。
在收集的293株肺炎克雷伯菌分离株中，31.05%（91株）对碳青霉烯类耐药并产生碳青霉烯酶，肠道携带率为22.12%。在耐碳青霉烯类肺炎克雷伯菌分离株中，40.65%（37株）同时携带碳青霉烯酶基因。所有分离株均含有blaOXA - 48基因，blaNDM、blaVIM和blaKPC基因分别在30.76%、9.89%和2.19%的分离株中检测到。在这些分离株中，30.76%同时含有blaOXA - 48和blaNDM基因，8.79%同时含有blaOXA - 48和blaVIM基因，只有2.20%同时含有blaOXA - 48和blaKPC基因。此外，88.57%同时携带碳青霉烯酶基因的耐碳青霉烯类肺炎克雷伯菌分离株为基因相关菌株。
本研究揭示了耐碳青霉烯类肺炎克雷伯菌在肠道中的高携带率。因此，实施有效的筛查和诊断措施，并注重抗菌药物管理，对于预防这些耐药菌株的传播以及将其对早产儿造成的风险降至最低至关重要。
