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临床多重耐药革兰氏阴性菌中苯唑西林酶基因的流行情况

Prevalence of Oxacillinase Genes in Clinical Multidrug-Resistant Gram-Negative Bacteria.

作者信息

Ahmed Omar B, Bamaga Majid A

出版信息

Clin Lab. 2025 Mar 1;71(3). doi: 10.7754/Clin.Lab.2024.240835.

Abstract

BACKGROUND

The emergence of OXA-type beta-lactamases has become a significant threat to public healthcare systems and may lead to prolonged hospital stays and increased mortality rates among affected patients. This study aimed to determine the prevalence of oxacillinase resistance (OXA) genes in multidrug-resistant (MDR) Gram-negative bacteria.

METHODS

One hundred and six clinical isolates were collected from a stock of Gram-negative isolates and were identified and tested for antibiotic susceptibility and presence of OXA genes using polymerase chain reaction (PCR).

RESULTS

The most common detected isolate was Klebsiella pneumoniae (36.8%), followed by Escherichia coli (33%), Pseudomonas aeruginosa (16%), and Acinetobacter baumannii (14.2%). Out of these isolates, 97.4%, 87.2%, 84.6%, and 79.5% were resistant to ampicillin/sulbactam, cefotaxime, ceftazidime, and aztreonam, respectively. PCR results confirmed the presence of one or more OXA genes in 34% of the samples studied. The blaOXA-1 and blaOXA-10 genes were the most highly detected genes, followed by blaOXA-4 and blaOXA-51. The total number of Pseudomonas aeruginosa isolates was confirmed to carry at least one OXA gene (70.6%), whereas Acinetobacter baumannii, Klebsiella pneumoniae, and Escherichia coli were confirmed to carry at least one OXA gene (53.3, 28.2, and 22.9%, respectively). There was a significant association (p < 0.05) between the resistance genes and the type of isolate.

CONCLUSIONS

Pseudomonas aeruginosa and Acinetobacter baumannii are the most common MDR Gram-negative strains carrying OXA-type beta-lactamase genes. Monitoring of MDR pathogens in Gram-negative bacteria must be continuously undertaken to implement effective measures for infection control and prevention.

摘要

背景

OXA型β-内酰胺酶的出现已成为公共卫生保健系统的重大威胁,并可能导致受影响患者住院时间延长和死亡率增加。本研究旨在确定耐甲氧西林(OXA)基因在多重耐药(MDR)革兰氏阴性菌中的流行情况。

方法

从革兰氏阴性菌分离株库中收集106株临床分离株,并使用聚合酶链反应(PCR)对其进行鉴定、抗生素敏感性测试以及OXA基因检测。

结果

检测到的最常见分离株是肺炎克雷伯菌(36.8%),其次是大肠杆菌(33%)、铜绿假单胞菌(16%)和鲍曼不动杆菌(14.2%)。在这些分离株中,分别有97.4%、87.2%、84.6%和79.5%对氨苄西林/舒巴坦、头孢噻肟、头孢他啶和氨曲南耐药。PCR结果证实,在所研究的34%的样本中存在一个或多个OXA基因。blaOXA-1和blaOXA-10基因是检测到频率最高的基因,其次是blaOXA-4和blaOXA-51。已确认铜绿假单胞菌分离株总数中至少有一个OXA基因(70.6%),而鲍曼不动杆菌、肺炎克雷伯菌和大肠杆菌已确认至少携带一个OXA基因(分别为53.3%、28.2%和22.9%)。耐药基因与分离株类型之间存在显著关联(p<0.05)。

结论

铜绿假单胞菌和鲍曼不动杆菌是携带OXA型β-内酰胺酶基因的最常见多重耐药革兰氏阴性菌株。必须持续监测革兰氏阴性菌中的多重耐药病原体,以实施有效的感染控制和预防措施。

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