Microbiology Laboratory, King Faisal Specialist Hospital & Research Centre, Madinah, Kingdom of Saudi Arabia.
Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia.
J Med Life. 2024 Jan;17(1):41-49. doi: 10.25122/jml-2023-0189.
Multi-drug resistant (MDR) remain a major clinical problem. Infections caused by carbapenem-resistant strains are particularly difficult to treat. This study aimed to assess the clinical and epidemiological characteristics of MDR isolates. A total of 154 non-repetitive clinical isolates, including ( = 66), ( = 70), and other ( = 18), were collected from the Diagnostic Microbiology Laboratory at King Fahad Hospital of the University. Most isolates were collected from urine specimens ( = 50, 75.8%) and resistance against the third and fourth-generation cephalosporins (ceftriaxone, ceftazidime, cefixime, and cefepime) and fluoroquinolones (ciprofloxacin and levofloxacin) was assessed. Clonal relatedness analysis using enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) revealed two clones ( A and B), each comprising two strains. Most samples were collected from respiratory specimens (27.1%, 20 samples), and the strains showed overall resistance to most of the antimicrobials tested (54%‒100%). Moreover, clonal-relatedness analysis using ERIC-PCR revealed seven major clones of . These findings suggest nosocomial transmission among some identical strains and emphasize the importance of strict compliance with infection prevention and control policies and regulations. Environmental reservoirs could facilitate this indirect transmission, which needs to be investigated.
耐多药（MDR）仍然是一个主要的临床问题。由碳青霉烯类耐药株引起的感染尤其难以治疗。本研究旨在评估 MDR 分离株的临床和流行病学特征。从法赫德国王大学医院的诊断微生物学实验室共收集了 154 株非重复临床分离株，包括（=66），（=70）和其他（=18）。大多数分离株来自尿液标本（=50，75.8%），并评估了对第三代和第四代头孢菌素（头孢曲松、头孢他啶、头孢克肟和头孢吡肟）和氟喹诺酮类药物（环丙沙星和左氧氟沙星）的耐药性。采用肠杆菌重复基因间共识聚合酶链反应（ERIC-PCR）进行克隆相关性分析，发现了两个克隆（A 和 B），每个克隆包含两个菌株。大多数（=75.8%）样本来自呼吸道标本，这些菌株对大多数测试的抗菌药物表现出总体耐药性（54%-100%）。此外，采用 ERIC-PCR 进行的克隆相关性分析显示了 7 个主要的 克隆。这些发现表明一些相同菌株之间存在医院内传播，并强调了严格遵守感染预防和控制政策和法规的重要性。环境储库可能促进这种间接传播，需要进行调查。
