菲斯哈桑二世医院成人复苏环境中产生碳青霉烯酶和 BLSE 的肠杆菌流行情况

S. Kouara, J Branya, Z. Lebbar, M Mahmoud, G Yahyaoui
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摘要

产生碳青霉烯酶(EPCs)和广谱β内酰胺酶(E-BLSEs)的肠杆菌科细菌是一种新出现的威胁。本研究旨在明确 E-BLSE 和 EPC 的流行病学特征,确定它们在哈桑二世医院中心成人重症监护室住院患者中的流行率,并根据当地数据描述它们目前的抗生素耐药性特征,以便更好地管理患者。我们的研究是回顾性的,于 2022 年 1 月 1 日至 2022 年 12 月 31 日在非斯哈桑二世医院微生物实验室进行,为期一年,涉及从非斯哈桑二世医院成人重症监护病房的所有尿液、脓液、血液培养物和呼吸道样本中分离出的所有 E-BLSE 和 EPC 菌株。在此期间处理的 1,792 份细菌样本中,有 352 份对革兰氏阴性杆菌 (GNB) 呈阳性,其中包括 71 份 BMR,总患病率为 20.17%。在本研究中,我们保留了 71 株 BMR,其中包括产碳青霉烯酶肠杆菌,占 30.98% 的病例(22 株)和 49 株 E-BLSE B(64.01%)。肠杆菌中 EPCs 的总体流行率为 6.25%。以 blaOX-48 基因为主(45.45%),其次是 bla-NDM a(31.81%),最后是两种基因的 a(22.72%)。E-BLSE 的总体流行率为 14%。在这些 E-BLSE 分离物中,大肠埃希菌占大多数(59.18%),其次是肺炎克雷伯菌(32.65%)。然后是泄殖腔肠杆菌,分离率为(8.16%)。所有分离出的 EPC 肠杆菌都对喹诺酮类药物有抗药性。不过,我们的菌株对阿米卡星的敏感率为 98%,而对可乐定的敏感率为 100%。这项研究表明,成人重症监护环境中 EBLSE 和 EPC 的流行率很高。我们需要继续努力,在医院中及早发现这些生物媒介反应器,以控制它们在医院环境和社区中的传播。
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Prevalence of enterobacteria producing carbapenemases and BLSE in the adult resuscitation environment at Hassan ii hospital in Fes
Enterobacteriaceae producing carbapenemases (EPCs) and extended-spectrum betalactamases (E-BLSEs) are an emerging threat. The aim of this study is to specify the epidemiological profile of E-BLSEs and EPCs, determine their prevalence in patients hospitalized in the adult intensive care unit of the CHU Hassan II hospital center, and describe their current antibiotic resistance profile for better patient management based on local data. Our study is retrospective, carried out at the microbiology laboratory of CHU HASSAN II in Fez over a one-year period from January 1, 2022 to December 31, 2022, and concerns all E-BLSE and EPC strains isolated from all urine, pus, blood cultures and respiratory samples taken from adult intensive care units at CHU Hassan II in Fez. Of the 1,792 bacteriological samples processed during this period, 352 were positive for Gram-negative bacilli (GNB), including 71 BMR, giving an overall prevalence of 20.17%. During our study, we retained 71 BMR, including carbapenemase-producing enterobacteria with 30.98% of cases (22 strains) and 49 strains of E-BLSE B (64.01%). The overall prevalence of EPCs among enterobacteria was 6.25%. The blaOX-48 gene predominated at (45.45%), followed by bla-NDM a (31.81%).and finally the two genes with a (22.72%). The overall prevalence of E-BLSE was 14%. Among these E-BLSE, Escherichia coli constituted the majority (59.18%) of isolates, followed by Klebsiella pneumoniae with a rate of (32.65%). Then Enterobacter cloacae with a rate of (8.16%). All EPC enterobacteria isolated showed resistance to quinolones. However, the sensitivity of our strains to amikacin was 98%, while colistin showed a sensitivity rate of 100%. This study has shown that the prevalence of EBLSE and EPC in the adult intensive care setting is significant. We need to continue our efforts in early detection of these BMRs in hospitals to control their spread both in the hospital environment and in the community.
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