大肠杆菌定殖孕妇产生的广谱β -内酰胺酶的表型和基因型特征。

Q2 Medicine Infectious Diseases in Obstetrics and Gynecology Pub Date : 2020-01-23 eCollection Date: 2020-01-01 DOI:10.1155/2020/4190306
Nahed Ghaddar, Elie Anastasiadis, Rawad Halimeh, Ali Ghaddar, Ghassan M Matar, Antoine Abou Fayad, Nour Sherri, Rita Dhar, Wadha AlFouzan, Hoda Yusef, Mira El Chaar
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引用次数: 11

摘要

由产生扩展谱β -内酰胺酶(ESBL)的细菌引起的感染仍然是选择适当治疗的挑战,因为它们可能对许多其他类别的抗生素表现出共同耐药性。该研究的目的是在黎巴嫩贝鲁特筛查产生ESBL细菌的孕妇,以检查其表型和基因型特征,并研究ESBL定植与不良新生儿结局之间的关系。方法:在这项横断面研究中,308名怀孕35-37周的孕妇在一年的时间里进行了阴道样本研究。将样品分别镀在麦康基琼脂和选择性麦康基琼脂上,并添加头孢他啶。采用双盘协同试验证实了ESBL的表型,并对所有分离株进行了抗性基因blaSHV、blaTEM和blaCTX-M的PCR筛选。采用脉冲场凝胶电泳法研究了大肠杆菌分离株的克隆亲缘性。结果:308例女性中59例(19.1%)被产革兰氏阴性菌的ESBL定植。两名感染ESBL的母亲所生的婴儿被诊断为败血症。其他抗菌药物的敏感性分别为:复方新诺明39%、环丙沙星49.2%、庆大霉素91.5%、氨曲南18.6%、头孢吡肟35.6%。大多数分离株对美罗培南和亚胺培南高度敏感,敏感性为93.2%。对所有大肠杆菌分离株进行PCR,检测最常见的ESBL产生基因;blaCTX-M是优势基因(90.7%),其次是bletm(88.4%),最后是blaSHV(44.2%)。对34株大肠杆菌进行PFGE分析,发现22个不同的聚类相似性超过85%。结论:总之,本研究表明黎巴嫩孕妇携带ESBL的患病率很高。应开展进一步的研究,包括对孕妇进行持续筛查和对新生儿临床状况进行随访,以预见传播风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Phenotypic and Genotypic Characterization of Extended-Spectrum Beta-Lactamases Produced by Escherichia coli Colonizing Pregnant Women.

Introduction: Infections caused by extended spectrum beta lactamase (ESBL) producing bacteria continue to be a challenge for choosing the appropriate therapy since they may exhibit coresistance to many other classes of antibiotics. The aim of the study was to screen pregnant women for ESBL producing bacteria in Beirut, Lebanon, to examine their phenotypic and genotypic characterization and to study the association between ESBL colonization with adverse neonatal outcomes.

Method: In this cross-sectional study, vaginal samples from 308 pregnant women at 35-37 weeks of gestation were studied during a one-year period. The samples were plated on MacConkey agar and selective MacConkey agar supplemented with ceftazidime. Phenotypic confirmation of ESBL production was performed by double-disc synergy test and all isolates were screened by PCR for the resistance genes blaSHV, blaTEM, and blaCTX-M. Clonal relatedness of Escherichia coli isolates was investigated by pulsed-field gel electrophoresis.

Results: In total, 59 women out of 308 (19.1%) were colonized by ESBL producing gram negative bacteria. Two babies born to mothers colonized with ESBL were diagnosed with sepsis. The susceptibility rates of isolates to other antibiotics were 39% to co-trimoxazole, 49.2% to ciprofloxacin, 91.5% to gentamicin, 18.6% to aztreonam and 35.6% to cefepime. Most of isolates were highly sensitive to meropenem and imipenem, with a susceptibility of 93.2%. PCR was performed on all E. coli isolates to detect the most common ESBL producing genes; blaCTX-M was the predominant gene (90.7%), followed by blaTEM (88.4%) and finally blaSHV (44.2%). PFGE analysis of 34 E. coli isolates revealed 22 distinct clusters showing more than 85% similarity.

Conclusion: In conclusion, this study showed that Lebanon has a high prevalence of ESBL carriage in pregnant women. Further studies that include a continuous screening of pregnant women and follow up of their newborn clinical status should be conducted to foresee the risk of transmission.

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来源期刊
Infectious Diseases in Obstetrics and Gynecology
Infectious Diseases in Obstetrics and Gynecology Medicine-Obstetrics and Gynecology
CiteScore
3.80
自引率
0.00%
发文量
17
审稿时长
12 weeks
期刊介绍: Infectious Diseases in Obstetrics and Gynecology aims to disseminate new and important information to clinicians and other health care providers, scientists, and researchers involved in the study or treatment of infectious diseases, especially those affecting the female patient. Its ultimate aim is to advance knowledge and encourage research, thereby improving the prevention or diagnosis and treatment of patients affected by such diseases.
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