Shanta Ayasha Siddique, Islam Nahidul, Al Asad Mamun, Akter Kakoli, Habib Marnusa Binte, Hossain Md Jubayer, Nahar Shamsun, Godman Brian, Islam Salequl
Department of Microbiology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh.
Center for Health Innovation, Research, Action, and Learning-Bangladesh (CHIRAL Bangladesh), Dhaka 1205, Bangladesh.
Microorganisms. 2024 Aug 5;12(8):1589. doi: 10.3390/microorganisms12081589.
Carbapenems are the antibiotics of choice for treating multidrug-resistant bacterial infections. Metallo-β-lactamases (MBLs) are carbapenemases capable of hydrolyzing nearly all therapeutically available beta-lactam antibiotics. Consequently, this research assessed the distribution of two MBL genes and three β-lactamases and their associated phenotypic resistance in diarrheal and urinary-tract infections (UTIs) to guide future policies. Samples were collected through a cross-sectional study, and β-lactamase genes were detected via PCR. A total of 228 diarrheal bacteria were isolated from 240 samples. The most predominant pathogens were (32%) and spp. (7%). Phenotypic resistance to amoxicillin-clavulanic acid, aztreonam, cefuroxime, cefixime, cefepime, imipenem, meropenem, gentamicin, netilmicin, and amikacin was 50.4%, 65.6%, 66.8%, 80.5%, 54.4%, 41.6%, 25.7%, 41.2%, 37.2%, and 42.9%, respectively. A total of 142 UTI pathogens were identified from 150 urine samples. spp. (39%) and (24%) were the major pathogens isolated. Phenotypic resistance to amoxicillin-clavulanic acid, aztreonam, cefuroxime, cefixime, cefepime, imipenem, meropenem, gentamicin, netilmicin, and amikacin was 93.7%, 75.0%, 91.5%, 93.7%, 88.0%, 72.5%, 13.6%, 44.4%, 71.1%, and 43%, respectively. Twenty-four diarrheal isolates carried NDM-1 or VIM genes. The overall MBL gene prevalence was 10.5%. Thirty-six UTI pathogens carried either NDM-1 or VIM genes (25.4%). Seven isolates carried both NDM-1 and VIM genes. MBL genes were strongly associated with phenotypic carbapenem and other β-lactam antibiotic resistance. OXA imparted significantly higher phenotypic resistance to β-lactam antibiotics. Active surveillance and stewardship programs are urgently needed to reduce carbapenem resistance in Bangladesh.
碳青霉烯类抗生素是治疗多重耐药细菌感染的首选抗生素。金属β-内酰胺酶（MBLs）是一类能够水解几乎所有临床上可用的β-内酰胺类抗生素的碳青霉烯酶。因此，本研究评估了两种MBL基因和三种β-内酰胺酶的分布情况及其在腹泻和尿路感染（UTIs）中的相关表型耐药性，以指导未来的政策制定。通过横断面研究收集样本，并通过聚合酶链反应（PCR）检测β-内酰胺酶基因。从240份样本中总共分离出228株腹泻细菌。最主要的病原体是（32%）和spp.（7%）。对阿莫西林-克拉维酸、氨曲南、头孢呋辛、头孢克肟、头孢吡肟、亚胺培南、美罗培南、庆大霉素、奈替米星和阿米卡星的表型耐药率分别为50.4%、65.6%、66.8%、80.5%、54.4%、41.6%、25.7%、41.2%、37.2%和42.9%。从150份尿液样本中总共鉴定出142株UTI病原体。spp.（39%）和（24%）是分离出的主要病原体。对阿莫西林-克拉维酸、氨曲南、头孢呋辛、头孢克肟、头孢吡肟、亚胺培南、美罗培南、庆大霉素、奈替米星和阿米卡星的表型耐药率分别为93.7%、75.0%、91.5%、93.7%、88.0%、72.5%、13.6%、44.4%、71.1%和43%。24株腹泻分离株携带NDM-1或VIM基因。MBL基因的总体流行率为10.5%。36株UTI病原体携带NDM-1或VIM基因（25.4%）。7株分离株同时携带NDM-1和VIM基因。MBL基因与碳青霉烯类抗生素和其他β-内酰胺类抗生素的表型耐药性密切相关。OXA对β-内酰胺类抗生素的表型耐药性显著更高。迫切需要开展主动监测和管理项目，以降低孟加拉国的碳青霉烯类抗生素耐药性。
