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研究从患有败血症的儿科患者中分离出的大肠杆菌和肺炎克雷伯菌中的质粒介导的喹诺酮类耐药基因。

Study of plasmid mediated quinolone resistance genes among Escherichia coli and Klebsiella pneumoniae isolated from pediatric patients with sepsis.

机构信息

Medical Microbiology and Immunology, Mansoura Faculty of Medicine, Mansoura, Egypt.

Medical Microbiology and Immunology, Helwan Faculty of Medicine, Helwan, Egypt.

出版信息

Sci Rep. 2024 May 24;14(1):11849. doi: 10.1038/s41598-024-61357-z.

Abstract

The resistance to antibiotics in Gram-negative bacilli causing sepsis is a warning sign of failure of therapy. Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. coli) represent major Gram-negative bacilli associated with sepsis. Quinolone resistance is an emerging resistance among E. coli and K. pneumoniae. Therefore, the present study aimed to study the presence of plasmid-mediated quinolone resistance (PMQR) genes qnrA, qnrB, and qnrS by polymerase chain reaction (PCR) in E. coli and K. pneumoniae isolated from pediatric patients with sepsis. This was a retrospective cross-sectional study that included pediatric patients with healthcare-associated sepsis. The E. coli and K. pneumoniae isolates were identified by microbiological methods. PMQR genes namely qnrA, qnrB, and qnrS were detected in E. coli and K. pneumoniae isolates by PCR. The results were analyzed by SPPS24, and the qualitative data was analyzed as numbers and percentages and comparison was performed by Chi-square test, P was significant if < 0.05. The most prevalent gene detected by PCR was qnrA (75%), followed by qnrB (28.1%), and qnrS (25%). The most frequently detected qnr gene in E coli and K. pneumoniae was qnrA (28.8%, and 16.3% respectively). The present study highlights the high prevalence of ciprofloxacin resistance among E. coli and K. pneumoniae isolated from pediatric patients with healthcare-associated sepsis. There was a high frequency of PMQR genes in E. coli and K. pneumoniae isolated from pediatric patients. Therefore, it is important to monitor the spread of PMQR genes in clinical isolates to ensure efficient antibiotic use in those children. The finding denotes the importance of an antibiotics surveillance program.

摘要

革兰氏阴性杆菌引起败血症的抗生素耐药性是治疗失败的警告信号。肺炎克雷伯菌(Klebsiella pneumoniae)和大肠杆菌(Escherichia coli)是与败血症相关的主要革兰氏阴性杆菌。喹诺酮类耐药性是大肠杆菌和肺炎克雷伯菌中出现的一种新兴耐药性。因此,本研究旨在通过聚合酶链反应(PCR)检测儿科败血症患者分离的大肠杆菌和肺炎克雷伯菌中质粒介导的喹诺酮类耐药(PMQR)基因 qnrA、qnrB 和 qnrS 的存在。这是一项回顾性横断面研究,包括与医疗保健相关的败血症的儿科患者。通过微生物学方法鉴定大肠杆菌和肺炎克雷伯菌分离株。通过 PCR 检测大肠杆菌和肺炎克雷伯菌分离株中的 PMQR 基因 qnrA、qnrB 和 qnrS。使用 SPPS24 分析结果,定性数据以数字和百分比表示,并通过卡方检验进行比较,P 值<0.05 有统计学意义。通过 PCR 检测到的最常见基因是 qnrA(75%),其次是 qnrB(28.1%)和 qnrS(25%)。在大肠杆菌和肺炎克雷伯菌中最常检测到的 qnr 基因是 qnrA(分别为 28.8%和 16.3%)。本研究强调了从与医疗保健相关的败血症的儿科患者中分离的大肠杆菌和肺炎克雷伯菌对环丙沙星耐药率较高。从儿科患者分离的大肠杆菌和肺炎克雷伯菌中 PMQR 基因的频率较高。因此,监测 PMQR 基因在临床分离株中的传播以确保这些儿童有效使用抗生素非常重要。这一发现表明了抗生素监测计划的重要性。

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