Moradi Farhad, Akbari Maryam, Vakili-Ghartavol Roghayyeh, Ostovari Mohsen, Hadi Nahal
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Bacteriology & Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Heliyon. 2024 Aug 24;10(17):e36858. doi: 10.1016/j.heliyon.2024.e36858. eCollection 2024 Sep 15.
Detection of superbugs carrying Extended-spectrum β-lactamase (ESBL) and Carbapenemase resistance genes among hospitalized patients is crucial for infection control and prevention. The aim of this molecular study was to investigate the spread of ESBL and Carbapenemase-producing in two hospitals located in Southwest Iran.
One hundred clinical isolates of were randomly collected from two hospitals over a period of five months, from November 2023. The isolates were confirmed using biochemical and genotypic tests. According to the CLSI 2022 guidelines isolates that exhibited resistance to at least one of the three indicator cephalosporins or carbapenems were selected for evaluation of ESBL and carbapenemase production. This was done using a combination disk confirmatory test and the modified carbapenem inactivation method (mCIM). Finally, the presence of ESBLs and carbapenemase resistance encoding genes was assessed using PCR and specific primers.
Out of the 100 isolates, the percentage of antibiotic resistance was cefoxitin (29 %), cefixime (28 %), ceftazidime (26 %), cefotaxime (24 %), cefepime (22 %), ceftriaxone (21 %), imipenem (20 %), and meropenem (17 %). Additionally, thirty isolated strains were found to be multidrug-resistant. Out of these, twenty-seven strains demonstrated a potential for ESBLs, twenty strains for Carbapenemase, and seventeen strains for both ESBLs and Carbapenemase production. Moreover, the occurrence of ESBLs and carbapenemase genes was as follows: (25 %), (23 %), (20 %), (17 %), and (13 %). It is important to mention that we did not detect the and resistant genes among clinical isolates.
Based on the results, the existence of this type of resistance in hospital centers needs to be reevaluated in terms of empirical antibiotic prescribing. Additionally, it is recommended that infection control measures should be taken for public health. Also, it's suggested that hospital-acquired infections caused by superbug resistant strains should be addressed.
在住院患者中检测携带超广谱β-内酰胺酶（ESBL）和碳青霉烯酶耐药基因的超级细菌对于感染控制和预防至关重要。这项分子研究的目的是调查伊朗西南部两家医院中产生ESBL和碳青霉烯酶的细菌的传播情况。
从2023年11月起的五个月内，从两家医院随机收集了100株临床分离株。通过生化和基因测试对分离株进行确认。根据CLSI 2022指南，选择对三种指示性头孢菌素或碳青霉烯类药物中至少一种表现出耐药性的分离株，用于评估ESBL和碳青霉烯酶的产生情况。这通过联合纸片确证试验和改良碳青霉烯灭活方法（mCIM）来完成。最后，使用PCR和特异性引物评估ESBL和碳青霉烯酶耐药编码基因的存在情况。
在100株分离株中，抗生素耐药百分比分别为：头孢西丁（29%）、头孢克肟（28%）、头孢他啶（26%）、头孢噻肟（24%）、头孢吡肟（22%）、头孢曲松（21%）、亚胺培南（20%）和美罗培南（17%）。此外，发现30株分离菌株具有多重耐药性。其中，27株显示有产生ESBL的潜力，20株有产生碳青霉烯酶的潜力，17株既有产生ESBL的潜力又有产生碳青霉烯酶的潜力。此外，ESBL和碳青霉烯酶基因的出现情况如下：[具体基因名称及百分比未给出]（25%）、[具体基因名称及百分比未给出]（23%）、[具体基因名称及百分比未给出]（20%）、[具体基因名称及百分比未给出]（17%）和[具体基因名称及百分比未给出]（13%）。需要指出的是，我们在临床分离株中未检测到[具体未检测到的基因名称]和[具体未检测到的基因名称]耐药基因。
基于这些结果，需要根据经验性抗生素处方重新评估医院中心此类耐药性的存在情况。此外，建议针对公共卫生采取感染控制措施。还建议应对由超级细菌耐药菌株引起的医院获得性感染问题。
