Sohag大学医院多重耐药革兰氏阴性杆菌bla (NDM-1)基因表型鉴定及分子检测

Rasha R. Eid, G. Ismail, L. Yousef, Hesham M Hefny
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摘要

背景:产碳青霉烯酶肠杆菌科(CPE)是一个全球性的公共卫生问题。其中一个最重要的耐药特征与碳青霉烯水解β-内酰胺酶的产生有关,该酶赋予了几乎所有β-内酰胺的耐药能力。目的:确定索哈格大学医院临床分离的多重耐药革兰氏阴性杆菌中bla (NDM-1)基因的发生情况。方法:本研究于2017年2月至2019年1月在Sohag大学医院进行前瞻性研究,为期24个月。本研究从索哈格大学医院不同科室收治的患者的各种临床标本中分离出150株菌株,年龄从1岁到81岁不等。结果:本研究共纳入150例多重耐药革兰氏阴性杆菌感染患者,其中碳青霉烯类耐药100例(66.6%),敏感50例(33.3%)。两组患者年龄差异无统计学意义(p值=0.782)。同样,两组在性别分布上也没有显著差异(p值=0.636)。以手术部位感染最多(34%),其次为呼吸道感染(33.6%),两组间诊断差异无统计学意义(p值=0.25)。以肺炎克雷伯菌(33例)26例NDM-1基因阳性为主,其次为大肠杆菌(24例)14例。两组间有机物含量差异有统计学意义(p值=0.03)。结论:耐药肠杆菌在我国和埃及均有传播。
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Phenotypic Identification and Molecular Detection of bla (NDM-1) Gene in Multidrug Resistant Gram Negative Bacilli in Sohag University Hospital
Background: Carbapenemase-producing Enterobacteriaceae (CPE) represents a worldwide public health problem. One of the most important emerging resistance traits corresponds to the production of the carbapenem-hydrolysing β-lactamases, which confer resistance to almost all β-lactams Objectives : to determine the occurance of bla (NDM-1) gene among clinical isolates of multidrug resistant gram negative bacilli in Sohag University Hospital. Methodology: This study was prospectively conducted over a period of 24 months between Februray 2017 and January 2019, at Sohag university hospital. This study included 150 isolates obtained from various clinical specimens from patients admitted to different department in Sohag University Hospital with age ranged from 1 to 81 years old. Results : This study included 150 patients were infected by multi drug resistant gram negative bacilli, 100 of patients were resistant to carbapenem group (66.6%) and 50 patients were sensitive to carbapenem group (33.3%). There was no significant difference between the two groups regarding age (p value=0.782 ). Similarly, there was no significant difference between the two groups regarding sex distribution (p value=0.636). Most of cases was surgical site infection (34%) followed by respiratory tract infection (33.6) with no significant difference between groups regarding diagnosis (p value=0.25). In most of cases type of organism is klebsiella pneumonia (33 cases) 26 of them was positive NDM-1 gene followed by Escherichia coli (24 cases) 14 of them was positive NDM-1 gene. There is significant difference between groups regarding organism (p value=0.03). Conclusion : resistant enterobacteriacae are spreading in our locality and Egypt.
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