Goravey Wael, Tsui Clement K M, Ali Gawahir A, Najim Mostafa Suhail, Shunnar Khalid, Ibrahim Emad B, Ahmed Mazen A Sid, Maslamani Muna Al, Sultan Ali, Skariah Sini, Hadi Hamad Abdel
Communicable Diseases Centre, Hamad Medical Corporation, Doha, Qatar.
Infectious Diseases Research Laboratory, National Centre for Infectious Diseases, Singapore.
IJID Reg. 2024 Apr 20;11:100368. doi: 10.1016/j.ijregi.2024.100368. eCollection 2024 Jun.
Resistant infections are a major global public health challenge particularly for multidrug-resistant (MDR) isolates manifesting as bloodstream infections (BSIs).
To evaluate clinical, phenotypic, and genotypic characteristics of extended-spectrum beta-lactamase (ESBL) producing BSIs from Qatar.
Phenotypic ESBL from adult patients presenting with positive BSIs were collected between January 2019 to May 2020. Microbiological identification and characterization were performed using standard methods while genetic characteristics were examined through whole genome sequencing studies.
Of 151 episodes of BSI, 15 (10%) phenotypic ESBL isolates were collected. Recent travel was recorded in most cases (80%) with recent exposure to antimicrobials (27%). High-level resistance to quinolines, aminoglycosides, and cephalosporins was recorded (80-100%) while meropenem, tigecycline and colistin demonstrated universal susceptibility. Genomic evaluation demonstrated dominance of serotype Typhi sequence type 1 (93%) while antimicrobial resistance genes revealed dominance of aminoglycoside resistance (100%)S1 quinolones resistance (80%), ESBLs (86.7%), and paucity of AmpC resistance genes (6.7%).
Invasive MDR is mainly imported, connected to patients from high prevalent regions with recent travel and antimicrobial use caused by specific resistant clones. In suspected cases of multidrug resistance, carbapenem therapy is recommended.
耐药感染是一项重大的全球公共卫生挑战，尤其是对于表现为血流感染（BSI）的多重耐药（MDR）菌株而言。
评估卡塔尔产超广谱β-内酰胺酶（ESBL）的血流感染的临床、表型和基因型特征。
收集2019年1月至2020年5月期间出现血流感染阳性的成年患者的表型ESBL。使用标准方法进行微生物鉴定和特征分析，同时通过全基因组测序研究检查基因特征。
在151例血流感染病例中，收集到15株（10%）表型ESBL分离株。大多数病例（80%）有近期旅行史，近期有抗菌药物暴露史的占27%。记录到对喹诺酮类、氨基糖苷类和头孢菌素类的高水平耐药（80%-100%），而美罗培南、替加环素和黏菌素显示普遍敏感。基因组评估显示伤寒血清型1序列型占主导（93%），而抗菌药物耐药基因显示氨基糖苷类耐药占主导（100%）、喹诺酮类耐药占80%、ESBLs占86.7%，AmpC耐药基因较少（6.7%）。
侵袭性MDR主要是输入性的，与来自高流行地区且近期有旅行和使用抗菌药物的患者有关，由特定的耐药克隆引起。在怀疑多重耐药的病例中，建议使用碳青霉烯类治疗。
