Identification of Carbapenem Resistance among Enterobacteriaceae Pathogens Isolated from Clinical Samples in Shendi locality

Mosab Nouraldein Mohammed Hamad
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Abstract

Introduction: One of the most serious issues in medicine is the increasing resistance of Enterobacteriaceae to antimicrobial agent’s especially broad-spectrum antibiotics such as Cephalosporins and Penicillins. This fact is associated with higher mortality and morbidity rates, prolonged hospital stays, and increased treatment-related costs. Carbapenems are the last line for the treatment of infection caused by bacteria resistance to a broad spectrum of antibiotics. Objective: This study aimed to detect the Distribution of Carbepanems Resistance in Enterobacteriaceae Pathogens Isolated from Clinical Samples in the Shendi locality Method: Cross-sectional study and a laboratory-based study was carried out on 63 isolates from different specimens, 63 types of pathogenic bacteria were isolated and identified using Gram stain, biochemical reactions, and testing for their susceptibility to Carbapenems antibiotics was performed for all Enterobacteriaceae isolates. Result: The isolated Enterobacteriaceae comprising of 19.0(30.2%) E. coli, 17 (27.0%) K. pneumoniae, 13(20.6%) P. vulgaris, 5(7.9%) P. mirabilis, 1(1.6%) Enterobacter species, 3(4.8%) C.freundii and 5(7.9%) M. morganii.Carbapenem (Imipenem and meropenem) susceptibility testing showed that 36.0% of Enterobacteriaceae isolates were Carbapenem resistant.Conclusions: The study revealed the low resistance pattern of Enterobacteriaceae to Carbapenems. Despite that E. coli (19.0, 30.0%) was the most isolated organism, K. pneumonniae (7.0, 11.0%) was the most resistant isolate to Carbapenems. The urine sample had the highest degree of resistance. There was a correlation between patients with chronic diseases such as cancer and the resistance level to Carbapenems, while there was no statistical significance between the period of antibiotics usage and the degree of resistance.
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申地地区临床分离肠杆菌科病原菌碳青霉烯类耐药性鉴定
导论:医学上最严重的问题之一是肠杆菌科对抗菌药物特别是广谱抗生素(如头孢菌素和青霉素类)的耐药性日益增加。这一事实与较高的死亡率和发病率、住院时间延长以及治疗相关费用增加有关。碳青霉烯类药物是治疗细菌对多种抗生素耐药引起的感染的最后一线药物。目的:研究沈地地区临床标本分离的肠杆菌科病原菌对碳青霉烯类抗生素的耐药性分布。方法:采用横断面研究和实验室研究相结合的方法,对63株不同标本分离的病原菌进行革兰氏染色、生化反应鉴定,并对所有分离的肠杆菌科病原菌进行碳青霉烯类抗生素的药敏试验。结果:分离得到的肠杆菌科细菌中,大肠杆菌19.0种(30.2%),肺炎克雷伯菌17种(27.0%),寻常假单胞菌13种(20.6%),神奇假单胞菌5种(7.9%),肠杆菌1种(1.6%),弗伦迪胞杆菌3种(4.8%),莫氏分枝杆菌5种(7.9%)。碳青霉烯(亚胺培南和美罗培南)药敏试验结果显示,36.0%的肠杆菌科分离株对碳青霉烯耐药。结论:本研究揭示了肠杆菌科细菌对碳青霉烯类药物的低耐药模式。大肠杆菌(19.0%,30.0%)是分离最多的菌,肺炎克雷伯菌(7.0,11.0%)是对碳青霉烯类最耐药的菌。尿液样本的耐药性程度最高。癌症等慢性疾病患者对碳青霉烯类药物的耐药水平有相关性,而抗生素使用时间与耐药程度无统计学意义。
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