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2017 - 2019年波兰中部罗兹医科大学中央教学医院住院患者感染的分子流行病学

Molecular Epidemiology of Infections in Patients Hospitalized in 2017-2019 at the Central Teaching Hospital of Medical University of Lodz, Central Poland.

作者信息

Ptaszyńska Agata, Macieja Anna, Rosińska-Lewandoska Dominika, Bielec Filip, Machnicki Piotr, Brauncajs Małgorzata, Pastuszak-Lewandoska Dorota

机构信息

Department of Microbiology and Laboratory Medical Immunology, Medical University of Lodz, 92-213 Lodz, Poland.

Department of Microbiology and Pharmaceutical Biochemistry, Medical University of Lodz, 92-215 Lodz, Poland.

出版信息

Antibiotics (Basel). 2025 Feb 21;14(3):219. doi: 10.3390/antibiotics14030219.

Abstract

infection (CDI) represents a significant public health challenge globally, driven by its increasing prevalence, hypervirulent strains like ribotype 027 (RT027), and growing antibiotic resistance. This study aimed to evaluate the prevalence of RT027 and analyze molecular markers of vancomycin and metronidazole resistance in stool samples from CDI patients hospitalized in Poland between 2017 and 2019. A total of 200 stool samples from confirmed CDI cases were analyzed for the presence of RT027, (vancomycin resistance), and (metronidazole resistance) genes. DNA was extracted, and a polymerase chain reaction (PCR) was conducted using specific primers. Statistical associations between RT027 and resistance genes were evaluated using chi-square tests and logistic regression. RT027 was detected in 14% of samples. The gene, indicative of vancomycin resistance, was found in 52.5% of samples, while the gene, associated with metronidazole resistance, was present in 1.5% of cases. Co-occurrence of RT027 with was not statistically significant. The study revealed no significant association between RT027 and . Also, no significant association was observed between RT027 and due to the latter's low prevalence. This study highlights a concerning prevalence of among CDI cases, indicating widespread vancomycin resistance and challenging current treatment guidelines. While RT027 prevalence was moderate, no significant associations with vancomycin or metronidazole resistance were observed. These findings emphasize the need for molecular surveillance and improved antimicrobial stewardship to manage CDI effectively.

摘要

艰难梭菌感染(CDI)在全球范围内构成了重大的公共卫生挑战,这是由其日益增加的患病率、如核糖体分型027(RT027)等高毒力菌株以及不断增长的抗生素耐药性所驱动的。本研究旨在评估RT027的患病率,并分析2017年至2019年期间在波兰住院的CDI患者粪便样本中万古霉素和甲硝唑耐药性的分子标志物。对总共200份确诊CDI病例的粪便样本进行分析,以检测RT027、(万古霉素耐药性)和(甲硝唑耐药性)基因的存在。提取DNA,并使用特异性引物进行聚合酶链反应(PCR)。使用卡方检验和逻辑回归评估RT027与耐药基因之间的统计学关联。在14%的样本中检测到RT027。在52.5%的样本中发现了指示万古霉素耐药性的基因,而与甲硝唑耐药性相关的基因在1.5%的病例中存在。RT027与的共现无统计学意义。该研究表明RT027与之间无显著关联。此外,由于后者患病率较低,RT027与之间未观察到显著关联。本研究突出了CDI病例中令人担忧的患病率,表明万古霉素耐药性广泛存在,并对当前的治疗指南构成挑战。虽然RT027患病率中等,但未观察到与万古霉素或甲硝唑耐药性有显著关联。这些发现强调了进行分子监测和改善抗菌药物管理以有效管理CDI的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b7f/11939216/0af6d7baa75d/antibiotics-14-00219-g001.jpg

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