尼泊尔一家三级医院中引起尿路感染的大肠埃希菌和肺炎克雷伯菌的广谱β-内酰胺酶产量和 blaCTX-M 基因

Gaurab Pandey, Anmol Karki, Prashant Karki, Chattra Thapa
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引用次数: 0

摘要

背景和目的:尿路感染(UTI)是最常见的细菌感染,其中大肠埃希菌(E. coli)和肺炎克雷伯菌(K. pneumoniae)是主要病原体。这些病原体对抗生素的耐药率很高,并会产生广谱β-内酰胺酶(ESBL)。本研究通过表型和基因型技术调查了从尼泊尔一家三级医院就诊的UTI患者中分离出的大肠杆菌和肺炎双球菌的抗生素耐药性模式和ESBL产生情况:进行了一项横断面研究,对 4664 份疑似 UTI 病例的中段尿液标本进行了培养。对分离出的大肠杆菌和肺炎双球菌采用柯比鲍尔盘扩散法进行抗生素药敏试验。利用聚合酶链反应(PCR)对 blaCTX-M 基因进行基因型检测:结果:在处理的 4664 份尿液样本中,564 份(12.1%)对大肠杆菌(475 份,10.2%)和肺炎双球菌(89 份,1.9%)呈阳性。在总共 564 份研究样本中,267 份(47.3%)为 MDR 分离物(大肠杆菌:222 份,46.7%;肺炎双球菌:45 份,50.6%),96 份(17%)经双盘确证检验为 ESBL 阳性。在 24 个 ESBL 阳性的大肠杆菌和 6 个肺炎双球菌中,分别有 19 个(79.2%)和 3 个(50%)的 blaCTX-M 基因呈阳性:本研究表明,在尼泊尔城市医院环境中,引起UTIs的大肠埃希菌和肺炎双球菌的MDR和ESBL产生率很高。DOI: https://doi.org/10.55010/imcjms.18.014*通讯:Gaurab Pandey,尼泊尔加德满都博卡拉大学附属诺贝尔学院医学检验系。电子邮件:pandeygaurab67@gmail.com
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Extended spectrum beta-lactamase production and blaCTX-M gene in Escherichia coli and Klebsiella pneumoniae causing urinary tract infection at a tertiary care hospital in Nepal
Background and objective: Urinary tract infections (UTIs) are the most common bacterial infections where Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) are the predominating pathogens. These pathogens have a high rate of antibiotic resistance and exhibit the production of extended-spectrum beta-lactamase (ESBL). This study investigated the antibiotic resistance pattern and ESBL production of E. coli and K. pneumoniae isolated from patients with UTIs attending a tertiary care hospital in Nepal by both phenotypic and genotypic techniques. Materials and methods: A cross-sectional study was performed where 4664 mid-stream urine specimens from suspected UTI cases were cultured. Isolated E. coli and K. pneumoniae were subjected to antibiotic susceptibility testing by Kirby Bauer disc diffusion method. Genotypic detection of blaCTX-M gene was performed using polymerase chain reaction (PCR). Results: Out of 4664 urine samples processed, 564 (12.1%) were positive for E. coli (475, 10.2%) and K. pneumonia (89, 1.9%). Out of the total 564 studied samples, 267 (47.3%) were MDR isolates (E. coli: 222, 46.7%; K. pneumoniae: 45, 50.6%) and 96 (17%) were positive for ESBL by double disc confirmatory test. Out of 24 ESBL positive E. coli and 6 K. pneumoniae, 19 (79.2%) and 3 (50%) respectively were positive for blaCTX-M gene. Conclusion: This study indicates high prevalence of MDR and ESBL producing E. coli and K. pneumoniae causing UTIs at an urban hospital setting in Nepal. July 2024; Vol. 18(2):002. DOI: https://doi.org/10.55010/imcjms.18.014 *Correspondence: Gaurab Pandey, Department of Medical Laboratory Science, Nobel College Affiliated to Pokhara University, Kathmandu, Nepal. Email: pandeygaurab67@gmail.com
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