Suppr超能文献

在尼日利亚西南部一家私立三级医院就诊的患者中分离的肺炎克雷伯菌临床株中 OXA-48 和 NDM-1 碳青霉烯酶基因的分子检测。

Molecular detection of OXA-48 and NDM-1 carbapenemase genes among clinical isolates of Klebsiella pneumoniae recovered from patients attending a private tertiary hospital in Southwestern Nigeria.

机构信息

Department of Medical Laboratory Science, School of Public and Allied Health, Babcock University, Ilishan-Remo, Ogun State, Nigeria.

Molecular and Tissue Culture Laboratory, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria.

出版信息

BMC Infect Dis. 2024 Sep 13;24(1):970. doi: 10.1186/s12879-024-09869-x.

Abstract

There have been increasing reports of Klebsiella pneumoniae resistant to β-lactam antibiotics. This study aimed to determine the prevalence of some selected carbapenemase genes among clinical isolates of Klebsiella pneumoniae recovered from patients attending a private tertiary hospital in Southwestern Nigeria. The study was conducted over two months (February-March 2024). A total of 50 clinical isolates of Klebsiella pneumoniae from different clinical specimens were obtained from the Medical Microbiology Department, Babcock University Teaching Hospital (BUTH). The clinical isolates were then characterized using standard microbiological procedures and were tested for susceptibility to meropenem and other classes of antibiotics according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Polymerase Chain Reaction (PCR) detection for OXA-48 and NDM-1 carbapenemase genes was performed on the 50 clinical isolates. PCR analysis showed that 9 (18%) clinical isolates were positive for the OXA-48 gene, 22 (44%) were positive for the NDM-1 gene, 4 (8%) possessed both the OXA-48 and NDM-1 genes, and 23 (46%) possessed neither the OXA-48 nor NDM-1 genes. Antibiotic Susceptibility Testing (AST) revealed that all the clinical isolates were resistant to meropenem. In conclusion, this study demonstrates the presence of OXA-48 and NDM-1 genes in clinical isolates of Klebsiella pneumoniae recovered from patients attending a private tertiary hospital in Southwestern Nigeria, highlighting the role of ESBL (extended-spectrum beta-lactamase) as a major resistance mechanism alongside other mechanisms. Population-based surveillance programs should be implemented to monitor the prevalence and epidemiology of Klebsiella pneumoniae infections at the community level, facilitating early detection of outbreaks and identification of emerging antimicrobial resistance patterns. CORE TIP: This study highlights the significant prevalence of NDM-1 and OXA-48 carbapenemase genes among Klebsiella pneumoniae clinical isolates in a private tertiary hospital in Southwestern Nigeria, with 44% and 18% of isolates harboring these genes, respectively. Notably, 46% of isolates were resistant to carbapenems despite lacking these genes, suggesting alternative resistance mechanisms. The findings underscore the urgent need for enhanced surveillance, infection control measures, and antibiotic stewardship programs to combat the spread of multidrug-resistant Klebsiella pneumoniae in healthcare settings.

摘要

越来越多的报道称,肺炎克雷伯菌对β-内酰胺类抗生素产生了耐药性。本研究旨在确定在尼日利亚西南部一家私立 tertiary hospital 就诊的患者中分离的肺炎克雷伯菌临床分离株中一些选定的碳青霉烯酶基因的流行情况。该研究在两个月内(2024 年 2 月至 3 月)进行。从巴布科克大学教学医院(Babcock University Teaching Hospital,BUTH)的医学微生物学系获得了来自不同临床标本的 50 株肺炎克雷伯菌临床分离株。然后,通过标准微生物学程序对临床分离株进行了特征描述,并根据临床和实验室标准协会(Clinical and Laboratory Standards Institute,CLSI)指南对美罗培南和其他类别的抗生素的敏感性进行了检测。对 50 株临床分离株进行了 OXA-48 和 NDM-1 碳青霉烯酶基因的聚合酶链反应(PCR)检测。PCR 分析显示,9 株(18%)临床分离株 OXA-48 基因阳性,22 株(44%)NDM-1 基因阳性,4 株(8%)同时携带 OXA-48 和 NDM-1 基因,23 株(46%)既不携带 OXA-48 基因也不携带 NDM-1 基因。抗生素敏感性试验(Antibiotic Susceptibility Testing,AST)显示所有临床分离株均对美罗培南耐药。总之,本研究表明,在尼日利亚西南部一家私立 tertiary hospital 就诊的患者中分离的肺炎克雷伯菌临床分离株中存在 OXA-48 和 NDM-1 基因,这突显了 ESBL(extended-spectrum beta-lactamase)作为一种主要耐药机制的作用,同时还有其他机制。应实施基于人群的监测计划,以在社区层面监测肺炎克雷伯菌感染的流行情况和流行病学,从而促进对暴发的早期发现和新出现的抗微生物耐药模式的识别。核心提示:本研究强调了在尼日利亚西南部一家私立 tertiary hospital 中,NDM-1 和 OXA-48 碳青霉烯酶基因在肺炎克雷伯菌临床分离株中的重要流行率,分别有 44%和 18%的分离株携带这些基因。值得注意的是,尽管缺乏这些基因,46%的分离株对碳青霉烯类药物耐药,提示存在其他耐药机制。这些发现强调了加强监测、感染控制措施和抗生素管理计划的迫切需要,以遏制在医疗机构中传播的多药耐药性肺炎克雷伯菌。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/214c/11395985/adb63c7f1cb8/12879_2024_9869_Fig1_HTML.jpg

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验