Antimicrobial Drug Resistance Trends of Bacteria Causing Bloodstream Infections in a Diagnostic Centre in Lahore

Sara Minahil, K. Nazeer, Muhammad Faisal Bashir, Amina Asif, S. Riaz
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Abstract

Bacteraemia due to multidrug-resistant (MDR) bacteria, particularly those producing carbapenemase or extended-spectrum beta-lactamase (ESBL), causes a significant threat to patients and associated morbidity and mortality. The global rise in the incidence of bacteremia necessitates the rapid and accurate identification of pathogens to ensure effective patient health management. Objective: To investigate antimicrobial drug resistance trends among bacteria causing bloodstream infections from a diagnostic centre in Lahore. Methods: This research was conducted at the Institute of Microbiology and Molecular Genetics, University of the Punjab, Lahore and Citilab and Research Centre, Lahore, from January 2020 to December 2022. A total of 2919 blood samples were cultured to screen the bacteremia patients. Following standard protocols, four hundred twenty isolates proceeded for gram-staining, biochemical characterization, and antimicrobial susceptibility testing (AST). The AST results of each strain calculated multiple antibiotic resistance (MAR). Results: Of 420 bacterial isolates, Gram-negative and Gram-positive isolates accounted for 48.57% and 51.43%, respectively. The predominant pathogens were Staphylococcus epidermidis (48.10%) and Salmonella typhi (27.14%), with other significant pathogens including Klebsiella spp., Pseudomonas spp., Enterobacter, Acinetobacter spp., Escherichia coli, Staphylococcus aureus, Enterococcus spp., Citrobacter, Morganella morganii, and Proteus mirabilis. AST revealed high resistance to Cephalosporins, Nitrofurantoin, Fosfomycin, and Quinolones. In contrast, Carbapenems demonstrated notable sensitivity. Salmonella typhi and Staphylococcus epidermidis exhibit the highest MAR values. Conclusions: The study highlights the prevalence of multidrug resistance bacteremia-causing pathogens, with a concerning trend towards decreasing antibiotic efficacy.
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拉合尔诊断中心引起血液感染的细菌的抗微生物药物耐药性趋势
多药耐药(MDR)细菌引起的菌血症,特别是那些产生碳青霉烯酶或广谱β -内酰胺酶(ESBL)的细菌,对患者及其相关发病率和死亡率造成重大威胁。全球菌血症发病率的上升需要快速准确地识别病原体,以确保有效的患者健康管理。目的:了解拉合尔某诊断中心血流感染病原菌的耐药趋势。方法:本研究于2020年1月至2022年12月在拉合尔旁遮普省大学微生物学和分子遗传学研究所和拉合尔花旗实验室和研究中心进行。共培养2919份血样,筛选菌血症患者。按照标准方案,420个分离株进行革兰氏染色、生化表征和抗菌敏感性试验(AST)。各菌株AST结果计算多重抗生素耐药性(MAR)。结果:420株分离菌中,革兰氏阴性菌占48.57%,革兰氏阳性菌占51.43%。主要病原菌为表皮葡萄球菌(48.10%)和伤寒沙门菌(27.14%),其他主要病原菌为克雷伯氏菌、假单胞菌、肠杆菌、不动杆菌、大肠杆菌、金黄色葡萄球菌、肠球菌、柠檬酸杆菌、莫organella morganii和变形杆菌。AST对头孢菌素、呋喃妥因、磷霉素和喹诺酮类药物耐药。相比之下,碳青霉烯类表现出显著的敏感性。伤寒沙门氏菌和表皮葡萄球菌的MAR值最高。结论:该研究强调了引起多药耐药菌血症的病原体的流行,并有降低抗生素疗效的趋势。
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