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调查癌症患者中耐甲氧西林金黄色葡萄球菌的抗生素耐药模式。

Investigating the Antibiotic Resistance Pattern of MRSA in Cancer Patients.

作者信息

Shamakhteh F, Tajbakhsh E, Momtaz H

机构信息

Department of microbiology, Shahrekord branch, Islamic Azad University, Shahrekord, Iran.

出版信息

Arch Razi Inst. 2024 Dec 31;79(6):1297-1304. doi: 10.32592/ARI.2024.79.6.1297. eCollection 2024 Dec.

Abstract

The emergence of methicillin-resistant Staphylococcus aureus (MRSA) represents a significant public health concern among long-term hospitalized patients, particularly those with weakened immune systems, such as cancer patients. This is primarily due to MRSA's ability to resist antimicrobial agents and drugs. The objective of this study is to ascertain the antibiotic resistance pattern of MRSA in cancer patients admitted to hospitals in the southwest region of Iran. The samples obtained from the patients were cultivated on blood agar and EMB medium. Subsequently, the positive samples containing S. aureus were identified through the application of a phenotypic method. Subsequently, the cefoxitin antibiogram was employed for the isolation of MRSA. Furthermore, the isolates were subjected to testing for simultaneous drug resistance against 12 different antibiotics. To detect the presence of the mec gene, a molecular method was employed, namely the polymerase chain reaction (PCR) technique, and electrophoresis of the obtained products was conducted. Of the 41 S. aureus samples identified, 33 were found to be methicillin-resistant S. aureus (MRSA). Of the 33 MRSA isolates, the presence of the mec gene was confirmed, and they exhibited simultaneous drug resistance. Individuals with cancer, who frequently have indwelling catheters and receive a variety of drugs and blood products, are at an elevated risk of contamination with this bacterium due to its presence on their skin and the hands of healthcare providers. The indiscriminate use of drugs and the subsequent rise in drug resistance can contribute to prolonged hospitalization and even death among these individuals. Given that Ahvaz hospitals, particularly Bagai Hospital, serve as primary treatment centers for patients with incurable and cancerous conditions in southwestern Iran, it is of significant value and importance to investigate the resistance patterns observed in patients undergoing chemotherapy and post-transplantation.

摘要

耐甲氧西林金黄色葡萄球菌(MRSA)的出现是长期住院患者,尤其是免疫系统较弱的患者(如癌症患者)面临的重大公共卫生问题。这主要是由于MRSA具有抵抗抗菌剂和药物的能力。本研究的目的是确定伊朗西南部地区医院收治的癌症患者中MRSA的抗生素耐药模式。从患者身上采集的样本在血琼脂和伊红美蓝培养基上培养。随后,通过表型方法鉴定出含有金黄色葡萄球菌的阳性样本。随后,采用头孢西丁药敏试验分离MRSA。此外,对分离株进行了针对12种不同抗生素的同时耐药性检测。为了检测mec基因的存在,采用了一种分子方法,即聚合酶链反应(PCR)技术,并对所得产物进行电泳。在鉴定出的41份金黄色葡萄球菌样本中,有33份被发现是耐甲氧西林金黄色葡萄球菌(MRSA)。在这33株MRSA分离株中,mec基因的存在得到了证实,并且它们表现出同时耐药性。癌症患者由于皮肤上存在这种细菌以及医护人员手上携带该细菌,且经常留置导管并接受各种药物和血液制品,因此感染这种细菌的风险较高。药物的滥用以及随后耐药性的增加可能导致这些患者住院时间延长甚至死亡。鉴于阿瓦士的医院,特别是巴盖医院,是伊朗西南部治疗绝症和癌症患者的主要治疗中心,研究化疗和移植后患者的耐药模式具有重要的价值和意义。

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