留置导尿管中形成强生物膜的耐多药细菌增加CAUTI风险

G. H., Johny Tk, Bhat Sg
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引用次数: 0

摘要

现代医学的成就是由于留置生物医学装置的发展和广泛使用,如导尿管、心脏瓣膜、血管旁路移植、人工晶状体和人工关节等。导尿管生物膜引起的院内感染未经治疗,给患者带来巨大的健康风险。本研究主要对留置导尿管中强生膜菌的分离、分子鉴定、药敏分析和理化性质进行了研究。采用微滴平板法和刚果红琼脂法对34株分离菌株进行了强生膜分离。通过分子鉴定和系统发育分析,发现肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌、莫organella morganii和粪肠球菌是导管相关性尿路感染(CA-UTI)的常见病原体。经改良Kirby- Bauer法检测,所有强生物膜形成物均具有多重耐药能力,并计算多重抗生素耐药指数(Multiple Antibiotic Resistance, MAR)。所有强生物膜生产者均表现出多重抗生素耐药性。超过60%的被选菌株是强烈疏水的。自聚集和疏水性之间没有明显的联系。这些菌株的生物膜形成、多种抗生素耐药、疏水性和自聚集能力等特点使它们成为CA-UTI的有力候选者。
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Enhanced CAUTI Risk due to Strong Biofilm Forming MDR Bacteria in Indwelling Urinary Catheters
The achievement of modern medicine is due to development and extensive use of indwelling biomedical devices like urinary catheters, heart valves, Vascular bypass grafts, ocular lenses and artificial joints, among others. Untreated nosocomial infections due to urinary catheter- biofilms pose great health risk to patients. This study focuses on the isolation, molecular identification, antibiotic susceptibility profiling and physicochemical characterization of strong biofilm producers from indwelling urinary catheters. Out of 34 isolates 19 strong biofilm producers were segregated using Microtitre plate and Congo red agar methods. Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Morganella morganii and Enterococcus faecalis, which are common causative agents of Catheter-Associated Urinary Tract Infection (CA-UTI) were identified by molecular characterization and phylogenetic analyses. All strong biofilm formers were multi drug resistant by modified Kirby- Bauer method and Multiple Antibiotic Resistance (MAR) index was also calculated Further physicochemical characterization included hydrophobicity and autoaggregation assays. All the strong biofilm producers exhibited multiple antibiotic resistance. More than 60 per cent of the selected strains were strongly hydrophobic. No significant connection between autoaggregation and hydrophobicity was observed. All the characteristics of these strains including biofilm formation, multiple antibiotic resistance, hydrophobicity and auto aggregation abilities made them strong candidates for CA-UTI.
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