慢性肾脏病患者多重耐药菌的筛选与鉴定

Katyala Srilaxmi, Srinivas Munjam
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摘要

慢性肾脏疾病在普通人群中的总发病率超过10%,是一个越来越重要的公共卫生问题。感染风险的增加,特别是由多重耐药细菌引起的感染风险的增加,是慢性肾脏疾病的主要副作用之一。筛选和鉴定慢性肾脏疾病患者,特别是接受血液透析的患者的多重耐药细菌,以防止这些病原体的传播是至关重要的。因此,为了改善慢性肾病患者的预后,早期诊断和及时治疗耐药细菌至关重要。共筛选2219份医院样本中抗生素耐药菌。细菌生长阳性445份(20.05%),阴性1774份(79.94%)。当肾小球滤过率在30 ~ 59 ml/min/1.73m2,肾小球滤过率为30 ml/min/1.73m2时,CKD患者的多药耐药细菌感染率分别高出17%和43%。发现5株细菌具有多种抗生素耐药性。多种抗生素耐药指数(MAR)在0.3 ~ 0.7之间。经16S rRNA基因测序和系统发育分析,分离株分别为布甘肠杆菌、屎肠球菌、斯华普罗维登斯菌、水痘克雷伯菌和大肠杆菌。综上所述,筛选和鉴定多重耐药细菌对于预防和控制这些病原体的传播至关重要,有助于有效治疗慢性肾脏疾病患者的多重耐药。
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Screening and Characterization of Multidrug Resistant Bacteria from Chronic Kidney Disease Patients of Warangal
With an overall incidence of over 10% within regular population, Chronic kidney disease is an issue that is becoming more and more important in terms of public health. The enhanced risk of infection, especially those brought on by bacteria that are multi-drug resistant, is one of the main side effects of chronic kidney disease. It is essential to screen and identify multidrug resistant bacteria in chronic kidney disease patients, especially those receiving haemodialysis, in order to prevent the transmission of these pathogens. Hence, to improve outcomes for chronic kidney disease patients, early diagnosis and prompt treatment of drug-resistant bacteria are essential. A total of 2219 samples were screened for antibiotic resistant microbes in hospital samples. 445 samples tested positive (20.05 %) for bacterial growth and 1774 samples tested negative (79.94 %). The rate of multidrug resistance bacterial infections was 17% and 43% higher in CKD patients for estimated glomerular filtration rate between 30 and 59 ml/min/1.73m2 and glomerular filtration rate 30 ml/min/1.73m2 respectively. Five bacterial isolates were found to exhibit multi-antibiotic resistance. The Multiple Antibiotic Resistance (MAR) Index ranged from 0.3 to 0.7 across the isolates. The isolates were identified as Enterobacter bugandensis, Enterococcus faecium, Providencia stuartii, Klebsiella variicola, and Escherichia coli by 16S rRNA gene sequencing and phylogenetic analysis. In conclusion, screening and identification of multidrug resistance bacteria is essential to prevent and control the spread of these pathogens and will be helpful for the effective treatment of the multidrug resistance in chronic kidney disease patients.
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