Morgan Portia Abena, Ntiamoah Desmond Opoku, Asare Prince, Mintah Ishaque Siam, Osei-Wusu Stephen, Boadu Augustine Asare, Danso Emelia Konadu, Lamptey Ivy Naa Koshie, Afreh Emmanuel, Tetteh Amanda, Asante-Poku Adwoa, Otchere Isaac Darko, Yeboah-Manu Dorothy
Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
Infect Drug Resist. 2024 Dec 18;17:5663-5673. doi: 10.2147/IDR.S483529. eCollection 2024.
Patients with tuberculosis (TB) often harbor diverse bacteria in their sputum, including both commensal and opportunistic pathogens. This study aimed to characterize the sputum microbiota of TB patients before and after the intensive phase of anti-TB treatment and assess changes in bacterial diversity and antibiotic resistance profiles.
A total of 162 patients with TB (128 males, 34 females; age range 18-82 years) provided sputum samples at baseline, of which 72 provided follow-up sputum after two months of intensive phase treatment. Sputum samples were cultured on standard agar plates, and distinct colonies were identified by Gram staining and bio-typing using MALDI-TOF mass spectrometry. Antibiotic susceptibility testing of the identified Gram-positive and Gram-negative bacteria was performed using the Kirby-Bauer method according to the CLSI guidelines.
At baseline, 209 bacterial isolates were recovered, dominated by Gram-positive bacteria (GPB), particularly (19.6%) and (13.9%). After treatment, the isolation rate significantly decreased (from 129% to 95.8%; p = 0.000002), with a shift towards Gram-negative bacteria (GNB) dominated by . High rates of antibiotic resistance were observed for both the GNB and GPB, notably to ampicillin (86.7%), tetracycline (74%), amoxicillin (70.3%), and sulfamethoxazole (63%) for GNP, and PEN (76.9%) for the GPB. 53% of isolates were phenotypic Methicillin-resistant (MRSA) and 57.7% of suspected extended-spectrum (ESBL) producers were confirmed positive, predominantly carrying the gene.
The observed antibiotic resistance among the identified isolates, including MRSA and ESBL, underscores the need for routine antibiotic susceptibility testing and judicious antibiotic use in Ghana. Further research is needed to explore the long-term consequences of these microbiome shifts on TB treatment outcomes and risk of secondary infections.
肺结核（TB）患者的痰液中常常存在多种细菌，包括共生菌和机会致病菌。本研究旨在描述抗结核治疗强化期前后肺结核患者痰液微生物群的特征，并评估细菌多样性和抗生素耐药谱的变化。
共有162例肺结核患者（男性128例，女性34例；年龄范围18 - 82岁）在基线时提供了痰液样本，其中72例在强化期治疗两个月后提供了随访痰液样本。痰液样本在标准琼脂平板上培养，通过革兰氏染色和使用基质辅助激光解吸电离飞行时间质谱（MALDI-TOF）进行生物分型来鉴定不同的菌落。根据临床和实验室标准协会（CLSI）指南，使用 Kirby-Bauer 方法对鉴定出的革兰氏阳性菌和革兰氏阴性菌进行抗生素敏感性测试。
在基线时，共分离出209株细菌，以革兰氏阳性菌（GPB）为主，尤其是[具体细菌名称1]（19.6%）和[具体细菌名称2]（13.9%）。治疗后，分离率显著下降（从129%降至95.8%；p = 0.000002），细菌类型向以[具体细菌名称3]为主的革兰氏阴性菌（GNB）转变。革兰氏阴性菌和革兰氏阳性菌均观察到较高的抗生素耐药率，革兰氏阴性菌中对氨苄西林（86.7%）、四环素（74%）、阿莫西林（70.3%）和磺胺甲恶唑（63%）耐药率较高，革兰氏阳性菌中对青霉素（PEN，76.9%）耐药率较高。53%的[具体细菌名称4]分离株为表型耐甲氧西林金黄色葡萄球菌（MRSA），57.7%的疑似产超广谱β-内酰胺酶（ESBL）菌株被确认为阳性，主要携带[具体基因名称]基因。
在所鉴定的分离株中观察到的抗生素耐药性，包括耐甲氧西林金黄色葡萄球菌和超广谱β-内酰胺酶，强调了加纳进行常规抗生素敏感性测试和合理使用抗生素的必要性。需要进一步研究来探索这些微生物群变化对结核病治疗结果和继发感染风险的长期影响。
