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尼泊尔中部三级医疗中分离出的耐头孢噻肟肺炎克雷伯菌中blaCTX-M和blaSHV基因的流行情况:一项描述性横断面研究。

Prevalence of and Genes in Cefotaxime-Resistant Recovered from Tertiary Care at Central Nepal: A Descriptive Cross-Sectional Study.

作者信息

Sah Rani Kumari, Dahal Pragyan, Parajuli Ranjana, Giri Gorkha Raj, Tuladhar Era

机构信息

National College, Kathmandu, Nepal.

Grande International Hospital, Kathmandu, Nepal.

出版信息

Can J Infect Dis Med Microbiol. 2024 Jan 8;2024:5517662. doi: 10.1155/2024/5517662. eCollection 2024.

Abstract

Urinary tract infections (UTIs) are highly prevalent globally, and various antibiotics are employed for their treatment. However, the emergence of drug-resistant uropathogens towards these antibiotics causes a high rate of morbidity and mortality. This study was conducted at the Microbiology Laboratory of Grande International Hospital from November 2021 to May 2022 and aimed to assess the prevalence of UTI caused by and their antibiotic susceptibility pattern with a focus on extended-spectrum beta-lactamases (ESBLs) and the prevalence of two genes ( and ) in cephalosporin-resistant . Altogether, 1050 urine samples were processed to obtain 165 isolates of . The isolates were identified by colony morphology and biochemical characteristics. Antimicrobial susceptibility tests (ASTs) were determined by the Kirby-Bauer disk diffusion method, and their ESBL enzymes were estimated by the combined disk method (CDM). Two ESBL genes ( and ) were investigated by polymerase chain reaction (PCR) in cefotaxime-resistant . Among the 1050 urine samples that were processed, 335 (31.9%) were culture-positive with 165 (49.2%) identified as The age group ≥60 years (30.3%) had greater susceptibility to bacterial infections. AST revealed that meropenem was highly effective (95.7% susceptibility), while ampicillin showed the least sensitivity (42.4%). Among the isolates, 86 were multidrug resistant (MDR) and 10 were extensively drug resistant (XDR). Of these, 46 MDR (96%) and 2 XDR (4%) were ESBL producers. The prevalence of ESBL genes ( and ) was 49.3% and 54.8%, respectively. The overall accuracy of CDM as compared to PCR for the detection of the gene was 55.26%. The prevalence of MDR harboring the and genes underscores the imperative role of ESBL testing in accurately identifying both beta-lactamase producers and nonproducers.

摘要

尿路感染(UTIs)在全球范围内高度流行,人们使用各种抗生素对其进行治疗。然而,尿路致病菌对这些抗生素产生耐药性,导致发病率和死亡率居高不下。本研究于2021年11月至2022年5月在格兰德国际医院微生物实验室进行,旨在评估由[具体细菌名称未给出]引起的UTI的患病率及其抗生素敏感性模式,重点关注超广谱β-内酰胺酶(ESBLs)以及耐头孢菌素的[具体细菌名称未给出]中两个基因([基因名称未给出]和[基因名称未给出])的患病率。总共处理了1050份尿液样本,获得了165株[具体细菌名称未给出]分离株。通过菌落形态和生化特征对分离株进行鉴定。采用 Kirby-Bauer 纸片扩散法进行药敏试验(ASTs),并通过复合纸片法(CDM)评估其ESBL酶。通过聚合酶链反应(PCR)对耐头孢噻肟的[具体细菌名称未给出]中的两种ESBL基因([基因名称未给出]和[基因名称未给出])进行研究。在处理的1050份尿液样本中,335份(31.9%)培养呈阳性,其中165份(49.2%)被鉴定为[具体细菌名称未给出]。≥60岁年龄组(30.3%)对细菌感染的易感性更高。药敏试验显示,美罗培南高度有效(敏感性为95.7%),而氨苄西林的敏感性最低(42.4%)。在[具体细菌名称未给出]分离株中,86株为多重耐药(MDR),10株为广泛耐药(XDR)。其中,46株MDR(96%)和2株XDR(4%)是ESBL产生菌。ESBL基因([基因名称未给出]和[基因名称未给出])的患病率分别为49.3%和54.8%。与PCR相比,CDM检测[基因名称未给出]基因的总体准确率为55.26%。携带[基因名称未给出]和[基因名称未给出]基因的MDR[具体细菌名称未给出]的患病率强调了ESBL检测在准确识别β-内酰胺酶产生菌和非产生菌方面的重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a360/10789516/4dc8daac0335/CJIDMM2024-5517662.001.jpg

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