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从埃塞俄比亚南部医院收集的蟑螂中分离出产超广谱和金属β-内酰胺酶的革兰氏阴性细菌病原体。

Extended spectrum and metalo beta lactamase producing gram negative bacterial pathogens from cockroaches collected at hospital, Southern Ethiopia.

机构信息

School of Medical Laboratory, College of health sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, P.O.Box: 138, Ethiopia.

School of Medicine, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.

出版信息

Antimicrob Resist Infect Control. 2024 Aug 13;13(1):87. doi: 10.1186/s13756-024-01442-0.

Abstract

BACKGROUND

Cockroaches can pose a significant health risk in hospital environments because they may serve as reservoirs and vectors for nosocomial pathogens. Cockroaches harbor epidemiologically significant extended spectrum and metalo beta lactamase producing Gram negative bacterial pathogens, which complicate nosocomial infections.

OBJECTIVES

The main aim of this study is to determine aetiology and phenotypic extended spectrum and metalo beta lactamase producing Gram negative bacteria pathogens from cockroaches collected in hospitals.

METHODS

A cross-sectional study was employed from February to May 2022 to determine the antibiotic resistance producing bacterial isolates from cockroaches by giving special emphasis to metalo beta lactamase and extended spectrum beta lactamase production from different wards of WSUCSH. Cockroaches were collected with hands wearing sterile gloves. External homogenate was prepared and incubated microbiologically by using different culture media and differentiated biochemically. Antimicrobial susceptibility testing was performed by disk diffusion method. ESBL production was conducted using double disc synergy method and double disk method was used to detect MBL enzyme detection. Descriptive statistics was used to determine prevalence and percentage.

RESULT

Out of 245 cockroaches, 108 Gram negative bacteria were isolated. K. pneumoniae 29(26.9%) was the most predominant bacteria and Enetrobacter spp. 8(7.4%), was the least. All, K. pneumoniae, P. mirabilis, and Enterobacter isolates were pan-resistant to Ampicillin. P.aeruginosa and P.mirabilis antibiotics showed ≥ 80% resistant for amoxicillin/clavulanic acid antibiotics. Cefotaxime, ceftazidime, ceftriaxone and imipenem showed relative efficacy compared with other antibiotics. Out of 78 amoxicillin-clavulanic acid resistant isolates, 42(34.7%) were ESBL producers. ESBL production is more depicted by P. aeruginosa, A. baumannii, K. pneumoniae and E. coli. The overall prevalence of MBL production is 29(23.1%). K. pneumoniae P. aeruginosa, E.coli, A. baumannii, Enterobacter spp and K.oxytoca revealed MBL production.

CONCLUSION

The overall prevalence of ESBL and MBL producing nosocomial agents from hospital cockroaches was 34.7% and 23.1% respectively. P.aeruginosa, A.baumannii, K.pneumoniae and E.coli showed pronounced ESBL production. All bacterial isolates except P. mirabilis and C. freundii showed MBL production. The needed to evaluate our antibiotic stewardship program and antibiotic resistance detection for treatment is mandatory. The impact of cockroach as a source of AMR should be sought.

摘要

背景

蟑螂在医院环境中可能构成重大健康风险,因为它们可能是医院病原体的储源和传播媒介。蟑螂携带具有流行病学意义的扩展谱和金属 β-内酰胺酶产生的革兰氏阴性细菌病原体,使医院感染复杂化。

目的

本研究的主要目的是确定从医院收集的蟑螂中分离出的病因和表型扩展谱和金属 β-内酰胺酶产生的革兰氏阴性细菌病原体。

方法

2022 年 2 月至 5 月进行了一项横断面研究,通过特别强调从 WSUCSH 的不同病房分离产金属 β-内酰胺酶和扩展谱 β-内酰胺酶的细菌分离物,确定来自蟑螂的抗生素耐药性产生细菌分离物。用无菌手套收集蟑螂。制备外部匀浆并通过使用不同的培养基进行微生物培养,并进行生化区分。采用纸片扩散法进行抗菌药物敏感性试验。使用双碟协同法进行 ESBL 生产,使用双碟法检测 MBL 酶检测。采用描述性统计确定患病率和百分比。

结果

在 245 只蟑螂中,分离出 108 株革兰氏阴性菌。K. pneumoniae 29(26.9%)是最主要的细菌,Enetrobacter spp. 8(7.4%)是最少的。所有,K. pneumoniae、P. mirabilis 和 Enterobacter 分离株对氨苄西林均呈泛耐药。P. aeruginosa 和 P. mirabilis 抗生素对阿莫西林/克拉维酸抗生素的耐药率均≥80%。头孢噻肟、头孢他啶、头孢曲松和亚胺培南与其他抗生素相比具有相对疗效。在 78 株耐阿莫西林/克拉维酸的分离株中,有 42 株(34.7%)为 ESBL 产酶菌。ESBL 生产更多地表现在 P. aeruginosa、A. baumannii、K. pneumoniae 和 E. coli 中。产 MBL 的总体患病率为 29%(23.1%)。K. pneumoniae、P. aeruginosa、E. coli、A. baumannii、Enterobacter spp 和 K. oxytoca 均显示 MBL 产生。

结论

从医院蟑螂中分离出的产 ESBL 和 MBL 的医院病原体的总体患病率分别为 34.7%和 23.1%。P. aeruginosa、A. baumannii、K. pneumoniae 和 E. coli 表现出明显的 ESBL 生产。除 P. mirabilis 和 C. freundii 外,所有细菌分离株均产生 MBL。评估我们的抗生素管理计划和抗生素耐药性检测以进行治疗是强制性的。应寻求蟑螂作为 AMR 来源的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ad3/11321132/6262c9070177/13756_2024_1442_Fig3_HTML.jpg

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