Post-Transplant Fecal Carriage of Antibiotic Resistant and B-Lactamases-Producing Enterobacteriales among Renal Transplant Recipients.

Bindira Joshi, Santosh Kumar Yadav, Manju Shree Shakya Hada, Sabina Shrestha, Kalpana Kumari Shrestha, Pukar Chandra Shrestha, Bal Krishna Awal
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Abstract

Background: The intestinal colonization and transmission of antibiotic-resistant Enterobacteriales to renal transplant recipients may pose a threat to them because they are profoundly immunocompromised and vulnerable to infection. Hence, it is crucial to identify these antibiotic-resistant fecal Enterobacteriales harboring high-risk populations. The objective of this study was to determine antibiotic resistance as well as β-lactamases production in fecal Enterobacteriales among renal transplant recipients.

Methods: The stool samples, one collected from each transplant recipient, were processed for isolation and identification of Enterobacteriales and were tested for their antibiotic susceptibility, extended-spectrum β-lactamase, and metallo-β-lactamase production by standard methods.

Results: A total of 103 Enterobacteriales comprising of Escherichia coli (86.4%), Klebsiella species (11.7%), and Citrobacter species (1.9%) were isolated and more than 60% of the E. coli were found resistant to ceftazidime and ciprofloxacin and around half of the Klebsiella species were resistant to ceftazidime and fluroquinolones. The extended-spectrum β-lactamase production was seen in 3.4% and 8.3% and metallo-β-lactamase production in 24.7% and 33.3% of E. coli and Klebsiella species, respectively. The high proportion of β-lactamase-producers were resistant to piperacillin-tazobactam, meropenem, gentamicin, and amikacin than β-lactamases non-producers.

Conclusion: Since the antibiotic resistance is higher in fecal Enterobacteriales, each renal transplant recipient should be screened for these highly resistant intestinal colonizers after transplantation in order to prevent infections and to reduce the rate of transplant failure due to infections.

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肾移植受者移植后粪便中耐药和产B-内酰胺酶肠杆菌的携带情况。
背景:肾移植受者的肠道定植和耐抗生素肠杆菌的传播可能会对他们构成威胁,因为他们的免疫力极度低下,很容易受到感染。因此,识别这些携带高风险人群的耐抗生素粪便肠杆菌至关重要。本研究旨在确定肾移植受者粪便肠杆菌的抗生素耐药性和β-内酰胺酶产生情况:方法:对每位移植受者的粪便样本进行处理,以分离和鉴定肠杆菌,并通过标准方法检测其抗生素敏感性、广谱 β-内酰胺酶和金属-β-内酰胺酶的产生:结果:共分离出 103 个肠杆菌,包括大肠埃希菌(86.4%)、克雷伯氏菌(11.7%)和枸橼酸杆菌(1.9%),发现 60% 以上的大肠埃希菌对头孢他啶和环丙沙星耐药,约一半的克雷伯氏菌对头孢他啶和氟喹诺酮类耐药。分别有 3.4% 和 8.3% 的大肠杆菌和克雷伯氏菌产生广谱β-内酰胺酶,24.7% 和 33.3% 的大肠杆菌和克雷伯氏菌产生金属-β-内酰胺酶。与不产β-内酰胺酶的菌株相比,产β-内酰胺酶的菌株对哌拉西林-他唑巴坦、美罗培南、庆大霉素和阿米卡星的耐药性比例较高:由于粪便肠杆菌对抗生素的耐药性较高,因此每位肾移植受者在移植后都应筛查这些高耐药性肠道定植菌,以预防感染并降低因感染导致的移植失败率。
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CiteScore
1.40
自引率
0.00%
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81
审稿时长
15 weeks
期刊介绍: The journal publishes articles related to researches done in the field of biomedical sciences related to all the discipline of the medical sciences, medical education, public health, health care management, including ethical and social issues pertaining to health. The journal gives preference to clinically oriented studies over experimental and animal studies. The Journal would publish peer-reviewed original research papers, case reports, systematic reviews and meta-analysis. Editorial, Guest Editorial, Viewpoint and letter to the editor are solicited by the editorial board. Frequently Asked Questions (FAQ) regarding manuscript submission and processing at JNHRC.
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