Yengui Mariem, Trabelsi Rahma, Gdoura Radhouane, Hamieh Aïcha, Zerrouki Hanane, Rolain Jean-Marc, Hadjadj Linda
Department of Life Sciences, Research Laboratory of Environmental Toxicology, Microbiology and Health (LR17ES06), Faculty of Sciences of Sfax, University of Sfax, BP 1171, 3000 Sfax, Tunisia; Aix Marseille Univ, MEPHI, Faculté de Médecine et de Pharmacie, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
Department of Life Sciences, Research Laboratory of Environmental Toxicology, Microbiology and Health (LR17ES06), Faculty of Sciences of Sfax, University of Sfax, BP 1171, 3000 Sfax, Tunisia.
Infect Genet Evol. 2025 Sep;133:105787. doi: 10.1016/j.meegid.2025.105787. Epub 2025 Jun 18.
The main objective of this cross-sectional study was to investigate the prevalence of beta-lactam (cephalosporins or carbapenems) or colistin resistant bacteria. Those were isolated from urine samples in two private polyclinics located in the Sfax region, in southern Tunisia. From September 2021 to August 2022, 116 strains resistant to β-lactams or colistin were isolated, identified by MALDI-TOF, and their antibiotic susceptibility was assessed by disk diffusion method. Resistance genes were detected by real-time PCR, standard PCR, and sequencing. The results revealed that the 116 strains consisted predominantly of Enterobacteriaceae (92.2 %) and non-fermenting bacteria (7.8 %). Among these strains, 21 (18.1 %) were resistant to carbapenems, three (2.7 %) to colistin, including two strains of Klebsiella pneumoniae (1.7 %) exhibiting resistance to both carbapenems and colistin. In Enterobacteriaceae, bla, bla, and bla were found in 79.5 %, 46.7 %, and 40.2 % of strains, respectively. For these strains, the minimum inhibitory concentrations (MICs) of imipenem and ertapenem ranged from >32 to 6 μg/mL and > 32 to 2 μg/mL, respectively, with bla and bla detected in 21.7 % and 19.6 % of isolates, respectively. Seven A. baumannii isolates resistant to imipenem and meropenem (MICs >32 μg/mL and 8 μg/mL, respectively) carried bla (n = 5) and bla (n = 2). In addition, mutations in the mgrB gene conferring colistin resistance were identified in two isolates. Two K. pneumoniae were colistin-resistant and carried the bla gene. These results highlight the urgency of developing new strategies for the identification and surveillance of pathogenic strains in humans to effectively combat this growing public health threat in Tunisia.
这项横断面研究的主要目的是调查β-内酰胺类（头孢菌素或碳青霉烯类）或黏菌素耐药菌的流行情况。这些细菌是从突尼斯南部斯法克斯地区的两家私立综合诊所的尿液样本中分离出来的。2021年9月至2022年8月，分离出116株对β-内酰胺类或黏菌素耐药的菌株，通过基质辅助激光解吸电离飞行时间质谱（MALDI-TOF）进行鉴定，并采用纸片扩散法评估其抗生素敏感性。通过实时聚合酶链反应（PCR）、标准PCR和测序检测耐药基因。结果显示，这116株菌株主要由肠杆菌科细菌（92.2%）和非发酵菌（7.8%）组成。在这些菌株中，21株（18.1%）对碳青霉烯类耐药，3株（2.7%）对黏菌素耐药，其中包括2株肺炎克雷伯菌（1.7%）对碳青霉烯类和黏菌素均耐药。在肠杆菌科细菌中，分别有79.5%、46.7%和40.2%的菌株检测到bla、bla和bla。对于这些菌株，亚胺培南和厄他培南的最低抑菌浓度（MIC）分别为>32至6μg/mL和>32至2μg/mL，分别有21.7%和19.6%的分离株检测到bla和bla。7株对亚胺培南和美罗培南耐药的鲍曼不动杆菌分离株（MIC分别>32μg/mL和8μg/mL）携带bla（n = 5）和bla（n = 2）。此外，在两株分离株中鉴定出赋予黏菌素耐药性的mgrB基因突变。两株肺炎克雷伯菌对黏菌素耐药并携带bla基因。这些结果凸显了制定新策略以鉴定和监测人类致病菌株的紧迫性，从而有效应对突尼斯这一日益严重的公共卫生威胁。
