尼日利亚南南地区乌约市接受高效抗逆转录病毒疗法(HAART)的艾滋病毒/艾滋病患者中引起下呼吸道感染(LRTI)的细菌分离株多重耐药基因的分子特征及检测
MOLECULAR CHARACTERIZATION AND DETECTION OF MULTIDRUGRESISTANT GENE IN BACTERIAL ISOLATES CAUSING LOWER RESPIRATORY TRACT INFECTIONS (LRTI) AMONG HIV/AIDS PATIENTS ON HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) IN UYO, SOUTH-SOUTH NIGERIA.
作者信息
Okon R S, Onwuezobe I A, Edem E N, Bonne S, Ekpenyong E N, Uko N S, Nworie G M, George A
机构信息
Department of Biological Sciences, Akwa Ibom State Polytechnic, Ikot Osurua, Ikot Ekpene, Nigeria.
Dept. of Medical Microbiology and Parasitology, Faculty of Basic Clinical Sciences, University of Uyo, Nigeria.
出版信息
Ann Ib Postgrad Med. 2024 Dec 31;22(3):48-56.
BACKGROUND
Antibiotic-resistant genes (ARGs) pose a significant challenge in modern medicine, rendering infections increasingly difficult to treat as bacteria acquire mechanisms to resist antibiotics. Addressing ARGs necessitates a multifaceted approach, encompassing surveillance efforts to monitor their presence and the development of strategies aimed at managing and curbing the spread of antibiotic resistance. Hence, this study characterized the genetic determinants of antibiotic resistance among isolates responsible for Lower Respiratory Tract Infections (LRTIs) in People Living with HIV/AIDS (PLWHA) in Uyo.
METHODS
Sputum samples were collected from 61 LRTI suspects, with bacterial isolates identified using VITEK-2 technology. Polymerase chain reaction assays were employed to detect resistance genes within the isolates.
RESULTS
Results revealed a bacterial etiology in 39.3% of the samples, with a majority (79.2%) originating from St. Luke Hospital, Anua (SLHA), and the remainder (20.8%) from the University of Uyo Teaching Hospital (UUTH). Staphylococcus aureus emerged as the predominant isolate (46.6%), while resistance was notably high against Gentamicin and Sulphamethazole/Trimethoprim. Conversely, Azithromycin, imipenem, clindamycin, erythromycin, and ceftriaxone displayed relatively lower resistance levels across all isolates. Notably, four resistance genes CTX-M, Aac, KPC, and MecA were identified, with CTX-M detected in all multidrug-resistant isolates. This underscores the predominantly community-acquired nature of resistance as conferred by CTX-M.
CONCLUSION
In conclusion, this study underscores the critical importance of continued vigilance and proactive measures in combating antibiotic resistance, particularly within vulnerable populations such as PLWHA. By elucidating the genetic mechanisms underlying antibiotic resistance, informed targeted interventions can be mitigated to curb threats posed by multidrug-resistant bacteria in clinical settings.
背景
抗生素耐药基因(ARGs)给现代医学带来了重大挑战,随着细菌获得抵抗抗生素的机制,感染越来越难以治疗。应对ARGs需要采取多方面的方法,包括监测其存在的监测工作以及制定旨在管理和遏制抗生素耐药性传播的策略。因此,本研究对乌约地区艾滋病毒/艾滋病感染者(PLWHA)下呼吸道感染(LRTIs)分离株中的抗生素耐药基因决定因素进行了表征。
方法
从61名下呼吸道感染疑似患者中采集痰液样本,使用VITEK-2技术鉴定细菌分离株。采用聚合酶链反应测定法检测分离株中的耐药基因。
结果
结果显示,39.3%的样本存在细菌病因,其中大多数(79.2%)来自阿努阿圣卢克医院(SLHA),其余(20.8%)来自乌约大学教学医院(UUTH)。金黄色葡萄球菌是主要的分离株(46.6%),而对庆大霉素和磺胺甲恶唑/甲氧苄啶的耐药性明显较高。相反,阿奇霉素、亚胺培南、克林霉素、红霉素和头孢曲松在所有分离株中的耐药水平相对较低。值得注意的是,鉴定出了四个耐药基因CTX-M、Aac、KPC和MecA,在所有多重耐药分离株中均检测到CTX-M。这突出了CTX-M赋予的耐药性主要为社区获得性的性质。
结论
总之,本研究强调了在抗击抗生素耐药性方面持续保持警惕和采取积极措施的至关重要性,特别是在PLWHA等弱势群体中。通过阐明抗生素耐药性的遗传机制,可以采取有针对性的干预措施来遏制临床环境中多重耐药细菌带来的威胁。