产多药耐药扩展谱β -内酰胺酶(ESBL)大肠杆菌临床样品的表型检测

M. Y. Iliyasu, A. Uba, E. Agbo
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引用次数: 13

摘要

对尼日利亚包奇市部分医院产广谱β-内酰胺酶(ESBL)大肠杆菌病原菌的耐多药(MDR)特征进行了临床-实验室调查。从不同年龄段(0 ~ 70岁以上)患者中分离出198株大肠杆菌,其中男134株,女85株,门诊126株,住院93株。药敏试验结果显示,氨苄西林(97.0%)、阿莫西林(96.0%)、头孢呋辛(81.3%)、头孢噻肟(85.4%)、头孢他啶(60.6%)等新一代头孢菌素耐药率较高。对头孢曲松(62.1%)、阿米卡星(71.7%)和亚胺培南(80.8%)敏感。在多重耐药分离株中,163株为ESBL产生菌,在31 ~ 40岁年龄组中发现的频率(26.9%),主要是男性(59.1%)和门诊患者(51.5%)。从粪便标本中分离出54株(27.3%),MDR和ESBL患病率分别为(27.1%)和(26.9%)。临床诊断结果显示,尿路感染病例中MDR患病率为29.5%,ESBL产生率为28.2%,胃肠炎患病率为25.3%,ESBL产生率为25.8%。这些结果表明,大肠杆菌病原菌的多药耐药与ESBL产生之间存在很强的关联。本研究中阿米卡星和亚胺培南的敏感性提倡在使用传统β -内酰胺类抗生素观察到耐药率增加的情况下使用碳青霉烯作为治疗选择。关键词:耐多药(MDR),广谱β-内酰胺酶(ESBL),尿路感染(UTIs),胃肠炎,碳青霉烯类,β-内酰胺类抗生素
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Phenotypic detection of multidrug resistant extended-spectrum beta-lactamase (ESBL) producing Escherichia coli from clinical samples
A clinico-laboratory investigation of multidrug resistant (MDR) characteristics of extended spectrum β-lactamase (ESBL) producing Escherichia coli pathotypes from some hospitals in Bauchi metropolis, Nigeria, was carried out. A total of 198 E. coli isolates were recovered from different patients’ age group (0 to above 70 years), comprising of 134 males and 85 females, as both out-patient (126) and in-patient (93). The antimicrobial susceptibility tests show a high multidrug resistance among Ampicillin (97.0%), Amoxycillin (96.0%), the newer generation Cephalosporins like Cefuroxime (81.3%), Cefotaxime (85.4%) and Ceftazidime (60.6%). The isolates were sensitive to Ceftriaxone (62.1%), Amikacin (71.7%) and Imipenem (80.8%). Out of the multidrug resistant isolates, 163 were ESBL producers, with frequency of (26.9%) found within age group (31 to 40 years), mostly in males (59.1%) and out-patients (51.5%). Fifty four (27.3%) of the isolates were recovered from stool specimens with MDR and ESBL prevalence of (27.1%) and (26.9%) respectively. Based on clinical diagnosis, prevalence of MDR (29.5%) and ESBL production (28.2%) was found among cases of Urinary tract infections (UTIs), followed by Gastroenteritis (25.3%) and (25.8) respectively. These results indicate a strong association between multidrug resistance and ESBL production in E. coli pathotypes. The Amikacin and Imipenem sensitivity in this study advocates the usage of the carbapenem as the therapeutic alternative in the event of the increasing resistance rates observed with conventional beta-lactam antibiotics. Key words: Multidrug resistant (MDR), extended spectrum β-lactamase (ESBL), urinary tract infections (UTIs), gastroenteritis, carbapenem, beta-lactam antibiotics.
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