Bandić Pavlović Daniela, Pospišil Mladen, Nađ Marina, Vrbanović Mijatović Vilena, Luxner Josefa, Zarfel Gernot, Grisold Andrea, Tonković Dinko, Dobrić Mirela, Bedenić Branka
Department of Anesthesiology and Intensive Care, University of Zagreb School of Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia.
Department of Emergency Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia.
Pathogens. 2024 May 15;13(5):411. doi: 10.3390/pathogens13050411.
Multidrug-resistant (MDR) bacteria of the utmost importance are extended-spectrum β-lactamase (ESBL) and carbapenemase-producing Enterobacterales (CRE), carbapenem-resistant (CRAB), carbapenem-resistant (CRPA), methicillin-resistant (MRSA) and vancomycin-resistant spp. (VRE). In this study, an evaluation of MDR bacteria in surgical intensive care units in a tertiary referral hospital was conducted. The study aimed to characterize β-lactamases and other resistance traits of Gram-negative bacteria isolated in surgical intensive care units (ICUs). Disk diffusion and the broth dilution method were used for antibiotic susceptibility testing, whereas ESBL screening was performed through a double disk synergy test and an inhibitor-based test with clavulanic acid. A total of 119 MDR bacterial isolates were analysed. ESBL production was observed in half of the , 90% of the and all of the and isolates. OXA-48 carbapenemase, carried by the L plasmid, was detected in 34 and one and complex isolates, whereas NDM occurred sporadically and was identified in three isolates. OXA-48 positive isolates coharboured ESBLs belonging to the CTX-M family in all but one isolate. OXA-23 carbapenemase was confirmed in all isolates. The findings of this study provide valuable insight of resistance determinants of Enterobacterales and which will enhance surveillance and intervention strategies that are necessary to curb the ever-growing carbapenem resistance rates.
极其重要的多重耐药（MDR）细菌包括产超广谱β-内酰胺酶（ESBL）和产碳青霉烯酶的肠杆菌科细菌（CRE）、耐碳青霉烯鲍曼不动杆菌（CRAB）、耐碳青霉烯铜绿假单胞菌（CRPA）、耐甲氧西林金黄色葡萄球菌（MRSA）和耐万古霉素菌属（VRE）。在本研究中，对一家三级转诊医院外科重症监护病房中的MDR细菌进行了评估。该研究旨在鉴定在外科重症监护病房（ICU）分离出的革兰氏阴性菌的β-内酰胺酶及其他耐药特征。采用纸片扩散法和肉汤稀释法进行抗生素敏感性试验，而通过双纸片协同试验和基于克拉维酸的抑制剂试验进行ESBL筛查。共分析了119株MDR细菌分离株。在一半的[具体细菌名称1]、90%的[具体细菌名称2]以及所有的[具体细菌名称3]和[具体细菌名称4]分离株中观察到ESBL产生。在34株[具体细菌名称5]以及1株[具体细菌名称6]和[具体细菌名称7]复合分离株中检测到由L质粒携带的OXA-48碳青霉烯酶，而NDM偶尔出现，在3株[具体细菌名称8]分离株中鉴定到。除1株分离株外，所有OXA-48阳性分离株均同时携带属于CTX-M家族的ESBLs。在所有[具体细菌名称9]分离株中均证实存在OXA-23碳青霉烯酶。本研究结果为肠杆菌科细菌和[具体细菌名称10]的耐药决定因素提供了有价值的见解，这将加强监测和干预策略，这些策略对于遏制不断上升的碳青霉烯耐药率是必要的。
