伊朗炎症性肠病患者结肠活检分离株中质粒介导喹诺酮耐药基因的流行率：一项横断面研究
Prevalence of Plasmid-Mediated Quinolone Resistance Genes in Isolates From Colonic Biopsies of Iranian Patients With Inflammatory Bowel Diseases: A Cross-Sectional Study.
作者信息
Alipour Samira, Owrang Mina, Rajabnia Mohsen, Olfatifar Meysam, Kazemian Hossein, Houri Hamidreza
机构信息
Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences Tehran Iran.
Faculty of Medical Science, Sari Branch Islamic Azad University Sari Iran.
出版信息
Health Sci Rep. 2024 Dec 17;7(12):e70204. doi: 10.1002/hsr2.70204. eCollection 2024 Dec.
BACKGROUND AND AIMS
Emerging evidence suggests that ciprofloxacin and other quinolones can be effectively used as adjuncts to immunosuppressive therapy in managing inflammatory bowel disease (IBD). Clinical isolates of Enterobacterales frequently exhibit quinolone resistance. Additionally, increased IBD severity has been linked to the proliferation of Enterobacterales in the gut. This study aimed to explore the frequency of fluoroquinolone resistance and the presence of associated resistance genes in isolates obtained from intestinal biopsies of patients with IBD in Iran.
METHODS
In this research, we conducted a study that involved the isolation and examination of bacteria from inflamed ileal and/or colonic tissues of patients diagnosed with IBD, specifically ulcerative colitis (UC) and Crohn's disease (CD), during colonoscopy procedures. We collected demographic and clinical information from the patients. To identify strains that were resistant to quinolone antibiotics, we performed both phenotypic and molecular analyses.
RESULTS
From the colonic and ileal biopsies of 121 patients with IBD, we isolated 107 unique strains of . Among these strains, 18 (16.8%) were derived from patients with CD, and 89 (83.2%) came from those with UC. Antimicrobial susceptibility tests revealed that 61 out of 107 isolates (57%) of the isolates showed phenotypic resistance to at least one type of quinolone. Additionally, plasmid-mediated quinolone resistance (PMQR) genes, specifically , , and were detected in the strains linked to both UC and CD. Notably, there was a significant positive correlation observed between intestinal colonization by ciprofloxacin-resistant and the patients' history of extended ciprofloxacin antibiotic therapy.
CONCLUSION
Our results reveal that a significant number of patients with IBD carry quinolone-resistant . This colonization may pose a risk factor that could affect disease progression and contribute to potential complications.
背景与目的
新出现的证据表明，环丙沙星和其他喹诺酮类药物可有效用作免疫抑制治疗的辅助药物，用于治疗炎症性肠病（IBD）。肠杆菌科的临床分离株经常表现出喹诺酮耐药性。此外，IBD病情加重与肠道内肠杆菌科细菌的增殖有关。本研究旨在探讨伊朗IBD患者肠道活检分离株中氟喹诺酮耐药的频率以及相关耐药基因的存在情况。
方法
在本研究中，我们进行了一项研究，涉及在结肠镜检查过程中从诊断为IBD（具体为溃疡性结肠炎（UC）和克罗恩病（CD））患者的发炎回肠和/或结肠组织中分离和检测细菌。我们收集了患者的人口统计学和临床信息。为了鉴定对喹诺酮抗生素耐药的菌株，我们进行了表型和分子分析。
结果
从121例IBD患者的结肠和回肠活检中，我们分离出107株独特的菌株。在这些菌株中，18株（16.8%）来自CD患者，89株（83.2%）来自UC患者。药敏试验显示，107株分离株中有61株（57%）对至少一种喹诺酮类药物表现出表型耐药。此外，在与UC和CD相关的菌株中检测到质粒介导的喹诺酮耐药（PMQR）基因，特别是qnrA、qnrB和qnrS。值得注意的是，耐环丙沙星菌株在肠道的定植与患者长期使用环丙沙星抗生素治疗的病史之间存在显著正相关。
结论
我们的结果表明，大量IBD患者携带耐喹诺酮的肠杆菌科细菌。这种定植可能是一个危险因素，可能影响疾病进展并导致潜在并发症。
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