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产碳青霉烯酶肠杆菌科细菌血流分离株或菌血症患者中碳青霉烯酶产生与药敏模式及耐药基因的可能关联

Possible Association of Carbapenemase Production with Susceptibility Pattern and Resistance Genes Among Carbapenemase Producing Enterobacterales from Blood Isolates or Bacteremic Patients.

作者信息

Shakhatreh Muhamad Ali K, Al-Ghawrie Hadeel M, Meqdam Mamdoh M, Shakhatreh Zaid, Khair Iliya Y, Tabnjh Abedelmalek Kalefh, Jacob Jacob H, Khabour Mohammed O, Alzoubi Karem H

机构信息

Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan.

Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.

出版信息

Infect Drug Resist. 2025 May 16;18:2569-2579. doi: 10.2147/IDR.S519561. eCollection 2025.

Abstract

BACKGROUND

Bacteremia caused by strains is associated with increased mortality rates due to antibiotic resistance, including carbapenems. The current study investigated antimicrobial susceptibility, carbapenemase production, and the presence of resistance genes in e isolated from blood cultures.

METHODS

Eighty pure isolates were collected from positive blood cultures from four Jordanian hospitals. Antimicrobial susceptibility was investigated using the Kirby-Bauer method. Chromogenic culture media was used for the Hodge test, and the carbapenemase production was determined using the Carba NP test. The PCR technique was used to identify genes that confer resistance.

RESULTS

Most isolates were positive for (55%), followed by (37.5%) and (5%). The highest rates of resistance were observed against ampicillin (90%), cefazolin (76.7%), cefotaxime (70%), and ceftriaxone (65%). The lowest rate of resistance was observed against imipenem (13.7%). The frequencies of carbapenemase production, as determined by chromogenic culture media, the modified Hodge test, and the Carba NP Test, were 18.75%, 21.25%, and 10%, respectively. The identified carbapenemase resistance genes were KPC (10%), NDM (15%), VIM (5%), and OXA-48 (6.25%). A significant association (P < 0.05) was found between multidrug resistance and carbapenemase production.

CONCLUSION

A low percentage of carbapenem-resistant was observed among Jordanian patients with bacteremia. A significant association was observed between carbapenemase production and multi-drug resistance. The results can be used in the management of bacteremic patients in Jordan.

摘要

背景

由该菌株引起的菌血症与包括碳青霉烯类抗生素在内的抗生素耐药性导致的死亡率增加有关。本研究调查了从血培养物中分离出的大肠杆菌的抗菌药敏性、碳青霉烯酶产生情况以及耐药基因的存在情况。

方法

从约旦四家医院的阳性血培养物中收集了80株纯大肠杆菌分离株。采用 Kirby-Bauer 方法调查抗菌药敏性。使用显色培养基进行 Hodge 试验,并使用 Carba NP 试验测定碳青霉烯酶的产生情况。采用聚合酶链反应(PCR)技术鉴定赋予耐药性的基因。

结果

大多数分离株对大肠杆菌呈阳性(55%),其次是肺炎克雷伯菌(37.5%)和奇异变形杆菌(5%)。观察到对氨苄西林(90%)、头孢唑林(76.7%)、头孢噻肟(70%)和头孢曲松(65%)的耐药率最高。对亚胺培南的耐药率最低(13.7%)。通过显色培养基、改良 Hodge 试验和 Carba NP 试验测定的碳青霉烯酶产生频率分别为18.75%、21.25%和10%。鉴定出的碳青霉烯酶耐药基因有 KPC(10%)、NDM(15%)、VIM(5%)和 OXA-48(6.25%)。发现多重耐药与碳青霉烯酶产生之间存在显著关联(P < 0.05)。

结论

在约旦菌血症患者中观察到对碳青霉烯耐药的大肠杆菌比例较低。观察到碳青霉烯酶产生与多重耐药之间存在显著关联。这些结果可用于约旦菌血症患者的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b655/12091050/84a78672656b/IDR-18-2569-g0001.jpg

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